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Objectives To assess the efficacy and cost effectiveness of a home safety programme and a home exercise programme to reduce falls and injuries in older people with low vision.

Design Randomised controlled trial.

Setting Dunedin and Auckland, New Zealand.

Participants 391 women and men aged ≥(1) 75 with visual acuity of 6/24 or worse who were living in the community; 92% (361 of 391) completed one year of follow-up.

Interventions Participants received a home safety assessment and modification programme delivered by an occupational therapist (n = 100), an exercise programme prescribed at home by a physiotherapist plus vitamin D supplementation (n = 97), both interventions (n = 98), or social visits (n = 96).

Main outcome measures Numbers of falls and injuries resulting from falls, costs of implementing the home safety programme.

Results Fewer falls occurred in the group randomised to the …