Disparities between ambient, standard lighting and retinal acuities in community-dwelling older people: Implications for disability

OBJECTIVES: To examine three types of visual ability - ambient acuity, standard lighting acuity, and retinal acuity - and their relationship with self-reported disability. DESIGN: Cross-sectional prevalence survey. SETTING: New York, New York. PARTICIPANTS: Community-dwelling older people. MEASUREMENTS: 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. RESULTS: 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%. CONCLUSION: Better utilization of retinal acuity through optimal ophthalmologic care and improvement in lighting would likely reduce disability in older adults.