Discrepancies in the concordance of self-reported vision status and visual acuity in the Salisbury Eye Evaluation Study.

PURPOSE: To examine the association between self-rated vision and distance visual acuity by race and other factors.

DESIGN

Cross-sectional analysis within a longitudinal, population-based cohort study.

PARTICIPANTS AND CONTROLS: Two thousand five hundred twenty individuals, 65 to 84 years of age, including 666 black participants and 1854 white participants.

METHODS

All participants reported their self-rated vision score. Binocular distance visual acuity was assessed. Based on the level of visual acuity and the self-reported vision score, participants were placed into concordant and discrepant groups.

MAIN OUTCOME MEASURES: Multinomial logistic regression models were used to examine the characteristics associated with concordant and discrepant groups.

RESULTS

Black participants were more likely to be represented in the discordant group that reported good vision but had acuity worse than 20/40. In the multivariate analysis, a per-year decrement in years of education received increased the odds of being in both discrepant groups, one that reported good vision but had a visual acuity worse than 20/40 (odds ratio, 1.21; P<0.0001) and the other discrepant group that reported bad vision but had a visual acuity of 20/40 or better (odds ratio, 1.04; P<0.0001). A per-year decrement in years of education received also seemed to explain the excess risk of black race in the discrepant group that reported good vision but had a visual acuity worse than 20/40.

CONCLUSIONS

Given the socioeconomically driven discrepancies in self-reported vision status, self-reported vision status should be used cautiously in surveillance surveys, especially when assessing vision inequalities between socioeconomic groups.

FINANCIAL DISCLOSURE(S): The author(s) have no proprietary or commercial interest in any materials discussed in this article.