(HealthDay News) – For older adults, vision measured in the clinic is generally better than that measured at home, according to a study published online Nov. 21 in JAMA Ophthalmology.

Anjali M. Bhorade, MD, from the Washington University School of Medicine in St. Louis, and colleagues conducted a cross-sectional study from 2005–2009 involving 126 patients with glaucoma and 49 without (aged 55–90 years) to compare vision measured in the clinic and the home.

For participants with and without glaucoma, the researchers found that the mean scores for all vision tests were significantly better in the clinic than in the home. For binocular distance visual acuity (DVA), compared with home, 29% of those with glaucoma and 39% of those with advanced glaucoma read two or more or three or more lines better, respectively, in the clinic. For the entire sample, near visual acuity (NVA) and contrast sensitivity with glare were also better in the clinic than the home (21% and 49%, respectively). The most significant factor associated with differences in vision between clinic and home was lighting. In areas tested for DVA and NVA, the median home lighting was 4.3 and 2.8 times lower than clinic lighting, respectively. For ≥85% of participants, home lighting was below that recommended.

“Knowledge that vision discrepancies between patient report and clinical testing may be owing to home lighting may initiate clinician-patient discussions to optimize home lighting and improve the vision of older adults in their homes,” the authors write.

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