Abstract
To examine three types of visual ability-ambient acuity, standard lighting acuity, and retinal acuity-and their relationship with self-reported disability. Cross-sectional prevalence survey. New York, New York. Community-dwelling older people. Ambient acuity assessed using a near reading card; standard lighting acuity and retinal acuity assessed using the Retinal Acuity Meter. Difficulty in activities of daily living was assessed according to self-report. Mean logMAR acuities were 0.44 (20/56) for ambient acuity, 0.33 (20/44) for standard lighting acuity, and 0.19 (20/31) for retinal acuity (all pairwise differences, P < .001). Given the distribution of disability by ambient acuity in this sample, improving ambient acuity to the level of retinal acuity could potentially reduce self-care disability 22%. Better utilization of retinal acuity through optimal ophthalmologic care and improvement in lighting would likely reduce disability in older adults.
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