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OBJECTIVES: To examine the association between visual impairment and falls in older people.

DESIGN: Cross‐sectional survey of eye disease with retrospective collection of falls data.

SETTING: Two postcode areas in the Blue Mountains west of Sydney, Australia.

PARTICIPANTS: All people 49 years of age and older were invited to participate, 3654 (82.4%) of 4433 eligible residents took part, and 3299 answered questions about falls.

MEASUREMENTS: Subjects had a detailed eye examination and answered questions about health and vision status, use of medication, and number of falls in the previous 12 months.

RESULTS: Tests of visual function that had a statistically significant association with two or more falls after adjustment for confounders were visual acuity (prevalence ratio (PR) 1.9 for visual acuity worse than 20/30), contrast sensitivity (PR 1.2 for a 1‐unit decrease at 6 cycles per degree), and …