Prevalence and Factors Associated With Self‐Reported Difficulty in Seeing Among Older Persons in Malaysia: A Cross‐Sectional Study From the National Health and Morbidity Survey 2023

OBJECTIVES: Although evidence on the ophthalmic impact of social determinants of health is growing, population-based data-particularly among older persons who may face unique barriers to eye care-remain limited. This study aimed to address this gap by determining the prevalence of and factors associated with difficulty in seeing among older persons in Malaysia. METHODS: Data from adults aged 60 years and older were analysed using the National Health and Morbidity Survey 2023, a cross-sectional survey with a two-stage stratified random sampling design. Self-reported difficulty in seeing (defined as those reporting 'some difficulty', 'a lot of difficulty' or being 'unable to see at all'), despite using corrective lenses, was assessed using the Washington Group Short Set on Functioning. Those reporting 'a lot of difficulty' or being 'unable to see at all' were classified as having a visual disability. Multivariable logistic regression was conducted for complex survey design. RESULTS: Among 2979 older persons, 25% reported difficulty in seeing, and 2% had a visual disability. Minority ethnic groups had higher odds of difficulty in seeing compared to Malays (aOR = 2.69; 95% CI: 1.85, 3.91). Rural residence (aOR = 1.63; 95% CI: 1.07, 2.49) and diabetes (aOR = 1.46; 95% CI: 1.10, 1.93) were also associated with increased odds. CONCLUSIONS: One in four older persons in Malaysia experiences visual difficulties, with Indigenous people, rural residence and diabetes as associated factors. Public health strategies should address these disparities through mobile outreach and enhanced diabetic eye screening to improve ocular health for Malaysia's ageing population.