OBJECTIVE. Our objective was to validate the construct of the Revised Self-Report Assessment of Functional Visual Performance (R–SRAFVP) for older adults with low vision resulting from age-related eye disease. METHOD. The 50-item draft of the R–SRAFVP was administered to 87 older adults with low vision. Construct validation included principal-components analysis and the known-groups method. RESULTS. Principal-components analysis revealed nine components (comprising 33 items): Personal Care, Oral Care, Meal/Laundry Preparation, Financial Management, Telephone Usage, Personal Preference Activities, Reading, Writing, and Functional Mobility. Cronbach’s α ranged from .72 to .84 for individual components and was .92 overall. Known-groups comparisons showed that participants with moderate to profound acuity loss or contrast sensitivity deficits reported significantly greater difficulty completing tasks on the R–SRAFVP than those with milder acuity loss or normal contrast sensitivity. CONCLUSION. The 33-item R–SRAFVP demonstrates adequate evidence of reliability and validity to evaluate the ability of older adults with low vision to complete vision-dependent activities of daily living.

OBJECTIVE. We sought to determine under what conditions brighter lighting improves reading performance. METHOD. Thirteen participants with typical sight and 9 participants with age-related macular degeneration (AMD) read sentences ranging from 0.0 to 1.3 logMAR under luminance levels ranging from 3.5 to 696 cd/m². RESULTS. At the dimmest luminance level (3.5 cd/m²), reading speeds were slowest at the smaller letter sizes and reached an asymptote for larger sizes. When luminance was increased to 30 cd/m², reading speed increased only for the smaller letter sizes. Additional lighting did not increase reading speeds for any letter size. Similar size-related effects of luminance were observed in participants with AMD. CONCLUSION. In some instances, performance on acuity-limited tasks might be improved by brighter lighting. However, brighter lighting does not always improve reading; the magnitude of the effect depends on the text size and the relative changes in light level.

PURPOSE. To examine the visual status of a cohort of older adults on an orthopedic unit to determine their level of available vision to complete everyday activities in the hospital setting. METHOD. A convenience sample of 50 people was recruited. A visual history was obtained, and participants’ glasses were inspected. Distance acuity, reading acuity, and contrast sensitivity were assessed using standardized screening charts. RESULTS. Of participants, 26% did not have their glasses with them until prompted, and 85% had glasses in poor condition. When tested wearing their habitual correction, 6% had low vision, 2% were blind, 41% had reading acuities worse than 20/25, and 28% had contrast sensitivity deficits. CONCLUSION. Visual impairment is prevalent in older adults, yet visual function is not routinely screened in hospitals. Occupational therapists should routinely inquire about patients’ visual status, inspect their glasses, and encourage regular eye examinations. Failure to address vision could lead to inaccurate evaluation results.

We investigated how induced blur affects performance on the Trail Making Test and Digit Symbol Test routinely used in occupational therapy cognitive evaluations. The study used a factorial design with both age (young and old adults) and simulated blur levels of near visual acuity (20/50 and 20/100) manipulated between participants. A sample of 124 healthy, community-living adults was used in the final analysis. Significant differences (p < .05) were found in performance for young participants between 20/50 and 20/100 blur level as well as between 20/20 and 20/100 blur level for the Digit Symbol Test. Scores for old participants decreased as a function of blur but were not significant. This study illustrates that cognitive evaluations used throughout the lifespan may require the appropriate visual acuity level to maximize performance. Occupational therapists’ understanding of client factors and their effect on performance is fundamental to the client evaluation process.