The association of multiple visual impairments with self-reported visual disability: SEE project

PURPOSE. This report examines the relationship bem-een psychophysical measu res of visual impairment and self-reported difficulty with everyday visual tasks in a population-based sample of individuals 65 years of age and older . METHODS. Community-dwelling residents (n = 2520) of Salisbury, MD, between the ages of 65 and 84 were recruited for the study. Visual acuity under nor mal and low luminance, contrast and glare sensitivity, stereoacuity, and vi sual fields were measured. Subjective physical disability was assessed with the Activities of Daily Vision Scale (ADVS). RESULTS. In multiple regression analyses adjusted for demographic factors, cognitive status, depression, and number of comorbid medical conditions, ea ch of the vision tests except low luminance acuity was independently associ ated with lower ADVS scores. The analyses indicate that a factor of 2 reduc tion in visual acuity or contrast sensitivity, comparable with that observe d in mild to moderate lens opacity, was associated with a three- to fivefol d odds of reporting difficulty with daily tasks. Although age alone was a s ignificant risk factor for disability, it was not associated with overall A DVS score, once visual impairment and other chronic medical conditions were taken into account. CONCLUSIONS. Visual acuity, contrast and glare sensitivity, stereoacuity, a nd visual fields are significant independent risk factors for self-reported visual disability in an older population. Visual impairment defined by acu ity alone is not the only dimension of the association with subjective disa bility. Additional vision measures are required to understand the impact of vision loss on everyday life.