In Reply. —Dr Tanton addresses the important question of prevention of falls in the visually impaired elderly population. In our study, the most important risk factors for falls were the use of certain topical and systemic medications. Although suggestive of a relationship, the estimated tripling of the odds of a fall associated with a visual field impairment was not statistically significant (95% confidence interval, 0.94 to 9.8). Thus, we confined our advice about prevention to the need to caution patients about potential side effects of certain medications. Other investigators have found a relationship of visual impairment with falls and join Dr Tanton in calling for more consideration of prevention strategies. 1,2 Detection, prevention, and amelioration of visual impairment are of unequivocal importance. Once irreversible visual impairment has developed, other prevention strategies, in addition to canes, may include modification of dangerous environments with particular attention given to the home and gait