Poor balance or declining balance is directly impacted by vision.  If there is a deficit, you can be sure to see changes in balance.    3 systems that impact balance:

• Visual
• Proprioceptive 
• Vestibular 

 So imagine how low vision impacts this.  Imagine yourself walking in a dark space.  Many older adults are impaired by low vision and it is not even known.  Sometimes, it declines or changes before it is caught by the eye exam.  

Any deficit in joint and muscle feedback is going to minimize the amount of information that is given to the brain to establish balance.   The visual and proprioceptive combo is especially important if someone has any type of vertigo.   Vertigo can come and go and the person experiencing it needs to use the other supporting systems to compensate. When there is dysfunction in the vestibular system, the brain is working extra hard to keep the body upright and this can impact the brain's ability to spend energy on other things like memory, problem-solving, sequencing. Impacts of low vision.  

• Poor depth perception
• Poor peripheral vision
• Slow movement
• Objects appearing to bounce
• Sensitivity to light 
• Difficulty reading labels or print of any kind

 vision therapy:  This therapy works to balance out the visual system first and when it is working better, they incorporate vestibular work.  This connects the 2 systems to build the foundation needed for balance.
Also, consider an evaluation from a Neuro-optometrist who will complete an eye exam on a whole new level.  Beyond checking visual acuity but evaluating how the eyes are working together, their focus ability, scanning and tracking, periphery and visual perception.   

• Immediate changes you can provide to an environment to compensate for low vision: 
• Lighting - more is better.  Night lighting too.   
• Track lighting along the floor (like the movie theater)
• Use of red tape on corners hallways, door frames, and on steps or changes in floor height
• Put that same tape over the light switch plate on the wall to increase its perception/location
• Avoid busy floor patterns on carpets or tile
• Add railings and handholds 
• Use contrasting dishes and utensils and cups
• Bathroom magnification mirror
• Closet lighting 
• Contrast furniture from space using pillows or throws that are easily identifiable.  this makes it easier for the eye to find them in space.  
• Clothing:   use a red permanent marker on the inside label to help ID back from the front.  

Next steps:  talk to your MD about a neuro-optometrist if necessary.  With the evaluation, get vision exercises to work on at home.   You can request an OT specializing in low vision too.  
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