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A.J. Hofeldt, S.M. Albert; Disparities Between Potential and Ambient Vision in Community–Dwelling Elders . Invest. Ophthalmol. Vis. Sci. 2005;46(13):1907.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: To determine (1) if vision of community–dwelling elders is related to self–reported physical disabilities and (2) the potential for vision improvement. Methods: Visual acuities were measured in the private homes of 299 elderly subjects ranging from 70 to 99 years of age of which 93 were males and 206 were females. Each subject responded to a disabilities questionnaire. The RAM (Retinal Acuity Meter) and a near card having identical letters were used for testing. Each subject was tested for ambient acuity (near vision tested under home lighting), RAM attenuated acuity (about 33 millilamberts), and RAM potential acuity (about 460 millilamberts through a pinhole). Results: All three acuities were significantly interrelated (p<.0001). The means of the logMAR acuities were 0.45 for ambient, 0.34 for attenuated RAM, and 0.19 for potential RAM. There were 188 (63%) subjects in which the attenuated RAM acuity and 255 (85%) subjects in which the RAM potential acuity were better than the ambient acuity. The RAM potential acuity was better than the attenuated RAM acuity in 79 (26%) subjects and in this group the difference between ambient and the RAM acuities was .48 logMAR units. Men had slightly better ambient (p<.05) and RAM potential acuities (p<.02) than the females. Between groups differences were significant for ambient acuity (p=.04), attenuated RAM (p<.01), and RAM potential acuity (p<.03) for white, black, and Hispanic groups, listed in order of descending mean acuity. Several self–reported physical disabilities were significantly related to ambient acuity which included  difficulty cooking (p=.02),  difficulty light shopping (p=.01),  difficulty bathing (p=.02), and  any difficulty with ADL (bathing dressing, eating, or toileting) (p<.05). Conclusions: This study suggest that 63% of elderly subjects could see better by 0.23 logMAR units (about 2 lines) if home lighting is increased. An additional 26% of the subjects have a mean of 0.48 logMAR units (about 5 lines) of potential vision not improvable by simply increasing illumination. For this 26% of elderly subjects, the probably causes are cataract and inadequate refraction, both of which are correctable. Since self–reported disabilities are significantly related to ambient acuity, improving ambient acuity to the level of their potential acuity may reduce their physical disabilities.
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