ConclusionsIt was possible to adapt successfully an existing, widely used exercise intervention for falls prevention (FaME) for people with visual impairment. Adherence to the intervention was high with very low attrition rates. It was to be expected that there would be no difference between the two groups in the main outcome measure, fear of falling, but a further two reasons may have contributed to the finding: there was possible a sub-optimal dose of exercise and the majority of participants were found to be of low risk. Although the progression criteria were met, a future definitive trial should consider the development of strategies to increase physical activity and structured exercise at home, in order to reach recommended levels of activity. Stratification of those with low, moderate and high falls risk should also be explored and that should include an assessment of visual impairment and functional ability as those with better functional vision may be able to be integrated into mainstream programmes. A recruitment strategy should be discussed and agreed across recruiting organisations which should also could include primary care practices and involve the multidisciplinary team.