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.
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