Self-report assessments of health are commonly favoured indicators used in large scale nationally representative surveys as they can be readily and cost-effectively collected from large numbers of people; however, subjective assessments have been criticised. Using data from the Irish Longitudinal Study on Ageing (TILDA), this article examines the relationship between self-reported vision and measured visual acuity (logMAR). The analysis indicates that normal vision is well captured by a subjective response but there is a slight overidentification of visual impairment using self-reported vision. These findings are discussed in relation to social patterning of mis-reporting. Given the simplicity of the self-report assessment to administer and the correspondence between this and measured visual acuity, it is argued to be a suitable indicator of visual impairment in older people.

Preventing deterioration in vision is the best means of ensuring well-being is not negatively affected by changes to sight. In addition, ensuring vision problems are corrected where possible may lead to improvements in well-being.

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Visual impairment becomes more prevalent with age. Rather than a uniform decline in vision with age, the strength and direction of change varies between people. This study applies an analytical method that posits multiple trajectories in eyesight, allowing for a more specific description of developmental course of this health outcome and its relationship with social position. The analysis uses the responses of 2956 respondents, aged 60 years and over, followed over 8 years (five observations) as part of the English longitudinal study of ageing. At each observation respondents self-reported their general vision. Optimal matching (sequence analysis), hierarchical clustering, and multinomial logistic regression were used to describe the sequential data, produce a typology of vision trajectories, and examine the socio-demographic characteristics associated with different trajectories. Eight distinctive clusters of trajectories were identified. The probability of reporting different types of vision trajectory varies with a change in age; however, the magnitude of the age effect is associated with social position. Visual impairment in older people is an increasingly relevant area for policy focus, with the rapid growth and diversity of the older population. Identifying factors underpinning the patterning of changes in visual function is essential for developing evidence-based policy, which both meets the needs of those most at risk and increases cost-effectiveness of public health interventions.

The high costs of visual impairment are disproportionately felt by the worst off elderly. Both low wealth and low SSS significantly increase the risk of onset of visual impairment.