Prevalence of dry eye disease in the low vision population at the University of Colorado

Purpose: To evaluate the prevalence of diagnosed dry eye syndrome, meibomian gland dysfunction, and blepharitis amongst the low vision population. Methods: A retrospective analysis was conducted on patients seen in the University of Colorado Low Vision Rehabilitation Service between the dates of 12/1/2017 and 12/1/2022. 74 ICD-10 codes were used to identify patients as having dry eye syndrome or not having dry eye syndrome. Data was further analyzed to determine the prevalence of blepharitis and meibomian gland dysfunction using 29 blepharitis and 9 meibomian gland dysfunction ICD-10 codes. Data were also analyzed to determine the age and sex of the patients with diagnosed dry eye syndrome. Results: The percentage of patients with a diagnosis of dry eye syndrome by an eyecare provider was 38.02 %. The prevalence of dry eye syndrome by age group was 3.57 % for 0–19 years, 14.35 % for 20–39 years, 29.07 % for 40–59 years, 43.79 % for 60–79 years, and 46.21 % for 80 and above. The prevalence of meibomian gland dysfunction and blepharitis was 11.90 % and 9.1 % respectively. Dry eye syndrome prevalence amongst males was 31.59 % and 42.47 % for females. Conclusion: This study demonstrates that dry eye syndrome in the low vision population is a significant co-morbidity occurring in over a third of patients in the University of Colorado Low Vision Rehabilitation Service. These findings are meaningful as ocular comfort should not be overlooked while managing complex visual needs. (AU)

Predictors of Job Retention After Onset of Visual Impairment in Late Middle Age.

Objectives: We investigated factors associated with job retention after developing a visual impairment in late middle adulthood. Methods: Using longitudinal survey data from the Health and Retirement Study, we identified respondents who first reported poor eyesight or legal blindness at age 44-64 years in Waves 3-14 and who were employed in the previous wave. We conducted a multiple logistic regression analysis with job retention as the dependent variable and health and socioeconomic characteristics as independent variables. Results: Women, people who were married or partnered, and people with fair or better self-reported health were more likely to retain employment after vision loss, whereas people with more chronic health conditions were less likely to retain employment. Discussion: Poor health and chronic health conditions may prompt late middle-aged adults to leave the labor force after developing vision loss. Timely vocational rehabilitation services can help employed people with vision loss retain employment.

A smart handheld magnifier for reflowing printed text notices in public spaces.

PURPOSE: Individuals with reduced vision may rely on handheld magnifiers for near reading of texts on household items such as food packaging and far reading of information notices and signposts. Smartphones have become favoured magnification devices due to their pervasiveness. Users typically take a photo of the text, view the image with magnification and explore details by panning in two-dimensions. However, two-dimensional panning is cumbersome, confusing and slow. MATERIALS AND METHODS: To improve the magnification experience, we implemented a proof-of-concept magnifier that reflows text to fit the device's viewport width. The user navigates through the text by scrolling up/down. Our implementation relies on a novel pixel-based text reflow image analysis algorithm. RESULTS: The prototype can successfully reflow text printed on sheets of paper such as notices. Initial tests showed that users preferred the smart digital magnifier over ordinary magnification. CONCLUSIONS: More work is needed to successfully handle other important use cases such as electronic information boards and household product packaging. We discuss open challenges and future directions for smart magnifiers.

Employment and retirement among workers who develop vision loss in midlife.

BACKGROUND: Vision loss increases with age and is thus more likely to happen later in one's career. With more individuals working beyond typical retirement age, the possibility of experiencing vision loss while working has increased. OBJECTIVE: The purpose of this study was to investigate how developing vision loss during midlife affects employment and retirement. METHOD: Using longitudinal Health and Retirement Study data, we identified a sample of 167 workers, 44 to 64 years old, who developed vision loss and a matched comparison sample of 800 workers who did not. We explored job retention and retirement differences between the groups and differences between people with vision loss who retained jobs versus those who did not. RESULTS: Vision loss was associated with leaving the labor force, although there was a clear trend over time of increasing likelihood of job retention. Occupational category was associated with job retention and people who continued working had more favorable financial situations. Retirees with vision loss were more likely to report involuntary retirement and dissatisfaction with retirement. CONCLUSIONS: The decreasing likelihood of leaving the labor market after vision loss is an encouraging finding of this study. Workers who left the labor force after vision loss were more likely to be in precarious financial positions, and retirees did not have positive experiences with retirement. Assisting workers with vision loss to remain in the labor force is of vital importance, and increasing awareness and usage of free services for this population may reduce involuntary retirement and its negative consequences.

A retrospective big data study using healthcare insurance claims to investigate the role of comorbidities in receiving low vision services.

Introduction: The aim was to examine the association between physical and mental comorbidity with receiving low vision services (LVS). Methods: A retrospective study based on Dutch claims data of health insurers was performed. We retrieved data (2015-2018) of patients (≥18 years) with eye diseases causing severe vision loss who received LVS at Dutch rehabilitation organizations in 2018 (target group) and patients who did not receive LVS, but who received ophthalmic medical specialist care for glaucoma, macular, diabetic retinal and/or retinal diseases in 2018 (reference group). For examining the association between the patients' comorbidities and receiving LVS, multivariable logistic regression was used. The relative quality of five different models was assessed with the Akaike Information Criterion (AIC). Results: The study population consisted of 574,262 patients, of which 8,766 in the target group and 565,496 in the reference group. Physical comorbidity was found in 83% and 14% had mental comorbidity. After adjustment for all assumed confounders, both physical and mental comorbidity remained significantly associated with receiving LVS. In the adjusted model, which also included both comorbidity variables, the best relative quality was found to describe the association between mental and physical comorbidity and receiving LVS. Conclusions: Mental comorbidity seemed to be independently associated with receiving LVS, implying that the odds for receiving a LVS referral are higher in patients who are vulnerable to mental comorbidity. Physical comorbidity was independently associated, however, the association with receiving LVS might not be that meaningful in terms of policy implications. Providing mental healthcare interventions for people with VI seems warranted.

Korean version of the MNREAD acuity chart.

To investigate the efficacy of the Korean version of the Minnesota low vision reading chart. A Korean version consisting of 38 items was prepared based on the MNREAD acuity chart developed by the University of Minnesota. A linguist composed the representative sentences, each containing nine words from second and third grade levels of elementary school. Reading ability was measured for 20-35-year-old subjects with normal visual acuity (corrected visual acuity of logMAR 0.0 or better). The maximum reading speed (words per minute [wpm]) for healthy participants, reading acuity (smallest detectable font size), and critical print size (smallest font size without reduction of reading speed) were analyzed. The average age of the subjects was 28.3 ± 2.6 years (male:female ratio, 4:16). The average reading time for 38 sentences was 3.66 ± 0.69 s, with no differences in the average maximum reading speed between sentences (p = 0.836). The maximum reading speed was 174.2 ± 29.3 and 175.4 ± 27.8 in the right and left eye, respectively. Reading acuity was measured as logMAR 0.0 or better in 80% of the cases. All subjects showed a critical print size of 0.2 logMAR or better. The overall reading ability can be measured using the Korean version of the MNREAD acuity chart, thereby making it useful in measuring the reading ability of those with Korean as their native language.

Accuracy and Usability of Smartphone-Based Distance Estimation Approaches for Visual Assistive Technology Development.

Goal: Distance information is highly requested in assistive smartphone Apps by people who are blind or low vision (PBLV). However, current techniques have not been evaluated systematically for accuracy and usability. Methods: We tested five smartphone-based distance-estimation approaches in the image center and periphery at 1-3 meters, including machine learning (CoreML), infrared grid distortion (IR_self), light detection and ranging (LiDAR_back), and augmented reality room-tracking on the front (ARKit_self) and back-facing cameras (ARKit_back). Results: For accuracy in the image center, all approaches had <±2.5 cm average error, except CoreML which had ±5.2-6.2 cm average error at 2-3 meters. In the periphery, all approaches were more inaccurate, with CoreML and IR_self having the highest average errors at ±41 cm and ±32 cm respectively. For usability, CoreML fared favorably with the lowest central processing unit usage, second lowest battery usage, highest field-of-view, and no specialized sensor requirements. Conclusions: We provide key information that helps design reliable smartphone-based visual assistive technologies to enhance the functionality of PBLV.

An Urgent Call for Concussion Incidence Measures in Para Sport for Athletes with Vision Impairment: A Narrative Review.

Concussion in para athletes with vision impairment (VI) is poorly understood. Recently published studies have suggested that athletes with VI may be more likely to sustain sport-related concussions compared to non-disabled athletes and athletes with other impairment types. There is a critical need for objective concussion incidence measures to determine concussion injury rates and risks more accurately. The aim of this review was to examine the limited available evidence of concussion incidence rates across six different para sports for athletes with VI and encourage the future collection of concussion incidence data and the adoption of injury prevention strategies in VI para sport. A literature search was conducted using four unique databases, which formed the basis of this narrative review. Injury prevention strategies such as modifying sport rules, introducing protective equipment, and incorporating additional safety measures into the field of play have been introduced sporadically, but the effectiveness of most strategies remains unknown. More prospective, sport-specific research examining mechanisms of injury and risk factors for concussion injuries in athletes with VI in both training and competition is needed. This research will help inform the development of targeted injury prevention strategies to reduce the likelihood of concussion for athletes with VI.

Reconsidering Luria's speech mediation: Verbalization and haptic picture identification in children with congenital total blindness.

Current accounts of behavioral and neurocognitive correlates of plasticity in blindness are just beginning to incorporate the role of speech and verbal production. We assessed Vygotsky/Luria's speech mediation hypothesis, according to which speech activity can become a mediating tool for perception of complex stimuli, specifically, for encoding tactual/haptic spatial patterns which convey pictorial information (haptic pictures). We compared verbalization in congenitally totally blind (CTB) and age-matched sighted but visually impaired (VI) children during a haptic picture naming task which included two repeated, test-retest, identifications. The children were instructed to explore 10 haptic schematic pictures of objects (e.g., cup) and body parts (e.g., face) and provide (without experimenter's feedback) their typical name. Children's explorations and verbalizations were videorecorded and transcribed into audio segments. Using the Computerized Analysis of Language (CLAN) program, we extracted several measurements from the observed verbalizations, including number of utterances and words, utterance/word duration, and exploration time. Using the Word2Vec natural language processing technique we operationalized semantic content from the relative distances between the names provided. Furthermore, we conducted an observational content analysis in which three judges categorized verbalizations according to a rating scale assessing verbalization content. Results consistently indicated across all measures that the CTB children were faster and semantically more precise than their VI counterparts in the first identification test, however, the VI children reached the same level of precision and speed as the CTB children at retest. Overall, the task was harder for the VI group. Consistent with current neuroscience literature, the prominent role of speech in CTB and VI children's data suggests that an underlying cross-modal involvement of integrated brain networks, notably associated with Broca's network, likely also influenced by Braille, could play a key role in compensatory plasticity via the mediational mechanism postulated by Luria.

Low Vision Practice and Service Provision Among Optometrists in Ghana: A Nationwide Survey.

PURPOSE: To characterize practice patterns of low vision services among Optometrists in Ghana. METHODS: The nationwide cross-sectional survey identified entities through the Ghana Optometrists Association (GOA) registry and utilized a semi-structured questionnaire to consolidate survey information that comprises practitioners' demographics, available services, diagnostic equipment, barriers to service provision and utilization, and interventions. RESULTS: 300 Optometrists were identified, with 213 surveyed (71% response rate). About fifty percent (52.6%) were in private practice, and more than two-thirds (77%) did not provide low vision services. Most (≥70%) reported lack of assistive devices, and basic eye care examination kits as the main barriers to low vision service provision. Similarly, practitioners reported unawareness of the presence of low vision centres (76.1%), and high cost of low vision aids (75.1%) as the prime perceived barriers for patients to utilize low vision services. Continuous professional development and public education (89-90%) were suggested as interventions to improve the uptake of low vision services. After statistical adjustment, private facility type (Adjusted odds ratio [AOR] = 0.35, p = 0.010) and lack of basic eye examination kits (AOR = 0.32, p = 0.002) were significantly associated with reduced odds of low vision service provision. Conversely, ≥15 years of work experience (AOR = 6.37, p = 0.011) was significantly associated with increased odds of low vision service provision. CONCLUSIONS: Overall, the results indicate inadequate low vision coverage and service delivery. Government policies must be directed towards equipping practitioners with equipment and subsidize patient cost of treatment to optimize low vision care.

Real-world application of a smartphone-based visual acuity test (WHOeyes) with automatic distance calibration.

BACKGROUND: To develop and assess the usability of a smartphone-based visual acuity (VA) test with an automatic distance calibration (ADC) function, the iOS version of WHOeyes. METHODS: The WHOeyes was an upgraded version with a distinct feature of ADC of an existing validated VA testing app called V@home. Three groups of Chinese participants with different ages (≤20, 20-40, >40 years) were recruited for distance and near VA testing using both an Early Treatment Diabetic Retinopathy Study (ETDRS) chart and the WHOeyes. The ADC function would determine the testing distance. Infrared rangefinder was used to determine the testing distance for the ETDRS, and actual testing distance for the WHOeyes. A questionnaire-based interview was administered to assess the satisfaction. RESULTS: The actual testing distance determined by the WHOeyes ADC showed an overall good agreement with the desired testing distance in all three age groups (p>0.50). Regarding the distance and near VA testing, the accuracy of WHOeyes was equivalent to ETDRS. The mean difference between the WHOeyes and ETDRS ranged from -0.084 to 0.012 logMAR, and the quadratic weighted kappa (QWK) values were >0.75 across all groups. The test-retest reliability of WHOeyes was high for both near and distance VA, with a mean difference ranging from -0.040 to 0.004 logMAR and QWK all >0.85. The questionnaire revealed an excellent user experience and acceptance of WHOeyes. CONCLUSIONS: WHOeyes could provide accurate measurement of the testing distance as well as the distance and near VA when compared to the gold standard ETDRS chart.

Population-Level Associations Between Visual Impairment and Functional Difficulties in California.

PURPOSE: The prevalence of visual impairment is increasing, and there is a need to understand the functional implications. Using the American Community Survey (ACS) data, this study examined the relationship between visual impairment and functional difficulties in California. METHODS: Using the 2010-2014 and 2015-2019 ACS 5-year estimates from the U.S. Census, data were obtained for visual impairment and functional difficulties including hearing, cognitive, ambulatory, self-care, and independent living difficulties. The prevalence of vision impairment and each functional difficulty was calculated on the Medical Service Study Area (MSSA) level in California. Unadjusted and adjusted linear regression models were performed to estimate the association between visual impairment and each functional difficulty, adjusting for age, sex, race and ethnicity, education level, English-speaking ability, poverty status, health insurance status, and urbanity of residence location. RESULTS: The prevalence of visual impairment in California was 2.3% (659,502 of 28,794,572) in 2010-2014 and 2.3% (709,353 of 30,231,767) in 2015-2019 among the population ≥ 18 years old. There were statistically significant associations between the prevalence of vision impairment and increased prevalence of all functional difficulties, with the most positive correlation observed with ambulatory difficulty (slope estimate 0.58 ± 0.072 for 2010-2014 and 0.78 ± 0.082 for 2015-2019 for ambulatory difficulty). CONCLUSIONS: There may be population-level impacts of functional consequences from vision impairment, suggesting the need for neighborhood-level investigation and policy-based interventions to address the burden of vision impairment on the population level.

A Feasibility Study on a Portable Vision Device for Patients with Stroke and Brain Tumours.

This prospective, single-centre cohort study aimed to evaluate the impact of a portable vision reading device, OrCam Read, on vision-related quality-of-life and independent functional status in patients with low vision due to stroke or brain tumours. Six patients with poor visual acuity or visual field defects due to a stroke or a brain tumour were enrolled at a U.S. Ophthalmology Department. Participants were trained to use OrCam Read and given a loaner device for the 1 month duration of the study. Various assessments, including daily function tests, the National Eye Institute Visual Function Questionnaire-25, and the 10-item neuro-ophthalmic supplement, were administered at the first and last visits. Patients' experience with the device was evaluated with weekly telephone and end-of-study satisfaction surveys. The main outcome measures were the patient satisfaction with OrCam and the mean assessment scores between enrolment and final visits. The intervention with OrCam significantly improved patients' ability to complete daily tasks and participants reported good satisfaction with the device. The results also show non-significant improvement with distant activities, dependency, and role difficulties. Our findings demonstrate the feasibility of studying vision-related quality-of-life using a portable vision device in this patient population and pave the way for a larger study to validate the results of this study.

Access all areas: multisensory science exhibitions tailored toward blind, low-vision and diverse-needs communities.

Monash Sensory Science is a scientific outreach initiative specifically tailored to members of the community who are blind, have low vision and have diverse needs. The purpose of this initiative is to showcase Australian science and encourage greater participation in science from these often-overlooked communities. This article presents our experience in establishing Monash Sensory Science at Monash University and inspiring other institutions to launch similar outreach events.

Enhancing the Functional Performance of Patients with Late-Stage Age-Related Macular Degeneration Implanted with a Miniature Telescope using Rehabilitation Training.

INTRODUCTION: In this work, our aim is to report the functional outcomes of cataract surgery with smaller-incision new-generation miniature telescope (SING IMT) implantation followed by rehabilitation training in patients with central visual loss due to late-stage age-related macular degeneration (AMD). METHODS: This retrospective study included patients who were monocularly implanted with SING IMT and then followed a rehabilitation program based on 6 biweekly sessions focused on visual abilities, reading, writing, visual motor integration and mobility. A total of 11 participants were included in this study. Reading acuity (RA), reading speed (RS), and fixation stability (FS) were assessed biweekly at 6-, 8-, 10-, 12-, 14-, and 16-week follow-up visits after SING IMT implantation and at a final assessment at 24 weeks. Best-corrected distance visual acuity (BCDVA) was also measured at baseline and at the same postoperative timepoints. RESULTS: Mean baseline BCDVA was 12.5 ± 8.6 letter score. Both RA and RS were found to be significantly improved from the first rehabilitation session (6 weeks after surgery) to the last session (24 weeks after surgery). At the end of the rehabilitation program, mean RA was 0.45 ± 0.19 LogMAR and mean RS was 30.9 ± 17.6 words per minute. Moreover, all patients achieved a FS of 15 s or more after the last rehabilitation session. Most patients (55%) achieved an improvement of 15 letters in BCDVA at the end of the study. CONCLUSIONS: This study suggests that rehabilitation training can improve visual functions of patients with late-stage AMD implanted with SING IMT in real-world tasks such as reading skills.

Assessment of the Impact of a Head-mounted Augmented Reality Low Vision Aid on Vision and Quality of Life in Children and Young People with Visual Impairment.

Introduction: Electronic head-mounted low vision aids (LVAs) can help children and young people (CYP) to access schoolwork and leisure activities which they would otherwise struggle to be able to do with traditional optical or hand held LVAs. SightPlus uses a smartphone mounted in a virtual reality headset controlled using a Bluetooth joystick. It offers users 0.7-24.3× magnification alongside enhanced modes to maximise vision. Methods: Eighteen participants aged 8-16 years with reduced vision were given SightPlus to use at home for four weeks. Visual acuity was assessed with and without SightPlus along with reading performance, contrast sensitivity, functional vision and quality of life questionnaires. Results: Clinically significant improvements in distance vision (0.633logMAR SD ± 0.359), near vision (0.411logMAR SD ± 0.368), reading acuity (0.454LlogMAR SD ± 0.406) and critical print size (0.285logMAR ± 0.360) were seen when testing with SightPlus.However, there was a mean decrease in contrast sensitivity and reading speed when using SightPlus. Despite this, nine out of the 14 patients included for analysis indicated a preference to continue to use SightPlus. Of note, younger participants were more likely to show a preference for using SightPlus. All seven CYP aged 10 or under wanted to continue to use SightPlus; in contrast, only two of the seven participants aged 11 or over wanted to continue. Conclusions: Like the results in adult populations, SightPlus has been found to improve CYP visual functions. Older participants were less likely to want to continue to use SightPlus, potentially suggesting they have found other methods for managing sight loss.

Simulation of visual impairment in persons with normal vision for scientific research.

Simulation of visual impairment in healthy eyes has multiple applications in students' training, research and product development. However, due to the absence of an existing standard protocol, the method of simulation was left to the discretion of the researcher. This review aimed to outline the various methods of simulating visual impairment and categorising them. A scoping review of the relevant publications was conducted. Of the 1593 articles originally retrieved from the databases, 103 were included in the review. The characteristics of the participants, the method for simulation of the visual impairment in persons with normal vision and the level or type of visual impairment that was simulated were extracted from the papers. None of the methods of simulation can be judged as being superior to the others. However, electronic displays produced the most consistent form of visual impairment simulation.

Vision Need Profiles for the City of Richmond, Virginia: A Pilot Application of Calibration Methods to Vision Surveillance.

Purpose: People with vision problems (VPs) have different needs based on their age, economic resources, housing type, neighborhood, and other disabilities. We used calibration methods to create synthetic data to estimate census tract-level community need profiles (CNPs) for the city of Richmond, Virginia. Design: Cross-sectional secondary data analysis. Subjects: Anonymized respondents to the 2015 to 2019 American Community Survey (ACS). Methods: We used calibration methods to transform the ACS 5-year tabular (2015-2019) and Public Use Microdata estimates into a synthetic data set of person-level records in each census tract, and subset the data to persons who answered yes to the question "Are you blind or do you have serious difficulty seeing even when wearing glasses?" To identify individual need profiles (INPs), we applied divisive clustering to 17 variables measuring individual demographics, nonvision disability status, socioeconomic status (SES), housing, and access and independence. We labeled tracts with CNP names based on their predominant INPs and performed sensitivity analyses. We mapped the CNPs and overlayed information on the number of people with VP, the National Walkability Index, and an uncertainty measure based on our sensitivity analysis. Main Outcome Measures: Individual need profiles and CNPs. Results: Compared with people without VP, people with VP exhibited higher rates of disabilities, having low incomes, living alone, and lacking access to the internet or private home vehicles. Among people with VP, we identified 7 INP clusters which we mapped into 6 CNPs: (1) seniors (≥ age 65); (2) low SES younger; (3) low SES older; (4) mixed SES; (5) higher SES; and (6) adults and children in group quarters. Three CNPs had lower-than-average walkability. Community need profile assignments were somewhat sensitive to calibration variables, with 18 tracts changing assignments in 1 sensitivity analysis, and 4 tracts changing assignments in ≥ 2 sensitivity analyses. Conclusions: This pilot project illustrates the feasibility of using ACS data to better understand the support and service needs of people with VP at the census tract level. However, a subset of categorical CNP assignments were sensitive to variable selection leading to uncertainty in CNP assignment in certain tracts. Financial Disclosures: The author(s) have no proprietary or commercial interest in any materials discussed in this article.

Eccentric Viewing Training for Age-Related Macular Disease: Results of a Randomized Controlled Trial (the EFFECT Study).

Purpose: Eccentric viewing training for macular disease has been performed for > 40 years, but no large studies including control groups have assessed the benefits of this training. The EFFECT (Eccentric Fixation From Enhanced Clinical Training) study is a large randomized controlled trial of 2 types of eccentric viewing training. Design: Randomized controlled trial. Participants: Two hundred adults with age-related macular disease. Methods: Participants were randomized to either of the following: (1) a control group; (2) a group receiving supervised reading support; (3) a group receiving 3 sessions of training to optimize the use of their own preferred retinal locus; or (4) a group receiving 3 sessions of biofeedback training of a theoretically optimal trained retinal locus. All participants received standard low-vision rehabilitation. Main Outcome Measures: The primary outcome was patient-reported visual task ability measured on the Activity Inventory instrument at goal level. Secondary outcomes included reading performance and fixation stability. Results: There was no difference between groups on change in task ability (F(3,174) = 1.48, P = 0.22) or on any of the secondary outcome measures. Visual acuity and contrast sensitivity fell in all groups, suggesting that disease progression outweighed any benefit of training. Conclusions: Eccentric viewing training did not systematically improve task ability, reading performance, or fixation stability in this study. Our results do not support the routine use of eccentric viewing training for people with progressing age-related macular disease, although this training may help people with end-stage disease. Rehabilitation of an inherently progressive condition is challenging. Financial Disclosures: Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.

Nationwide Rapid Assessment of Avoidable Blindness (RAAB) in Armenia.

PURPOSE: This study aimed to estimate the prevalence and main causes of blindness and visual impairment in population aged 50 years and older in Armenia using Rapid Assessment of Avoidable Blindness (RAAB) methodology. METHODS: The study team randomly selected 50 clusters (each consisting of 50 people) from all 11 regions of Armenia. Data on participants' demographics, presenting visual acuity, pinhole visual acuity, principal cause of presenting visual acuity, spectacle coverage, uncorrected refractive error (URE), and presbyopia were collected using the RAAB survey form. Four teams of trained eye care professionals completed data collection in 2019. RESULTS: Overall, 2,258 people of 50 years and older participated in the study. The age- and gender- adjusted prevalence of bilateral blindness, severe and moderate visual impairment were 1.5% (95% CI: 1.0-2.1), 1.6% (95% CI: 1.0-2.2) and 6.6% (95% CI: 5.5-7.7), respectively.The main causes of blindness were cataract (43.9%) and glaucoma (17.1%). About 54.6% and 35.3% of participants had URE and uncorrected presbyopia, respectively. The prevalence of bilateral blindness and functional low vision increased with age and was the highest in participants 80 years and older. CONCLUSION: The rate of bilateral blindness was comparable with findings from countries that share similar background and confirmed that untreated cataract was the main cause of blindness. Given that cataract blindness is avoidable, strategies should be developed aiming to further increase the volume and quality of cataract care in Armenia.