Age-related vision loss (ARVL) is an often-overlooked health issue that affects a significant portion of the elderly population around the world. This progressive impairment not only challenges an individual’s visual capabilities but also has a considerable impact on their occupational engagement and overall quality of life. Occupational therapists are at the forefront of developing strategies to support individuals dealing with ARVL. A recent metasynthesis study, published in the ‘Canadian Journal of Occupational Therapy,’ has provided invaluable insights into the psychological adaptation strategies employed by older adults to maintain their independence and engagement in daily activities despite the challenges posed by ARVL.

DOI: 10.1177/0008417419834422

Vision is a critical sense that enables us to interact with the world effectively. As we age, our visual acuity often diminishes – a reality that countless older adults face every day. Age-related vision loss can lead to significant setbacks in life, particularly when it comes to engaging in various occupations, which, in this context, refers to all the activities that occupy our time, including self-care, work, and leisure.

Against this backdrop, a study titled “Adaptations to support occupational engagement with age-related vision loss: A metasynthesis study,” published in the ‘Canadian Journal of Occupational Therapy,’ offers insight into how older adults adapt psychologically to ARVL. The study, conducted by McGrath Colleen E. and Corrado Ann Marie, delves into 21 qualitative articles to comprehend how affected individuals adjust to their changing circumstances and sustain their occupational engagement.

The research categorizes the identified psychological strategies into five main themes: persisting with hope, positivity, and acceptance; portraying a self-image consistent with independence, competence, and self-reliance; using humor; relying on religious/spiritual beliefs; and comparing oneself to others, either favorably or unfavorably.

Persisting with Hope, Positivity, and Acceptance

Many older adults exhibit remarkable resilience in the face of ARVL, with hope and positivity playing a central role in their psychological adaptation. Acceptance does not imply resignation; rather, it indicates a level of adjustment wherein the individual acknowledges the reality of their situation and actively finds ways to work within their limitations. This positive outlook is essential as it can influence how effectively an individual with ARVL can continue with their activities and maintain a good quality of life.

Portraying a Self-Image of Independence

An important adaptation strategy uncovered by the study is the portrayal of a self-image that aligns with independence, competence, and self-reliance. Older adults with ARVL strive to maintain a sense of control over their lives, and they employ various techniques to ensure they can manage their daily tasks independently. This sense of self-efficacy is crucial for their psychological well-being and encourages continued engagement in activities that are meaningful to them.

Using Humor

Humor serves as a powerful tool for many facing adversities, including ARVL. It allows individuals to navigate through difficult situations, providing relief and diminishing the perceived severity of their impairments. By incorporating humor into their lives, older adults can alleviate stress and anxiety, fostering a more positive and resilient outlook.

Reliance on Religious and Spiritual Beliefs

For many older adults, religious and spiritual beliefs provide comfort and strength in the face of diminishing sight. This deep-seated faith helps them to cope with their vision loss, offering a sense of peace and an avenue to accept their changing circumstances.

Comparing Oneself to Others

Comparing oneself to others who are in similar or different situations can influence psychological adaptation. While some older adults may find motivation and hope by looking at those who have managed their vision loss successfully, others might experience feelings of relief by realizing that there are others in more challenging situations.

The study’s findings aim to equip occupational therapists with the necessary knowledge to support clients with ARVL better. By understanding the psychological strategies used by older adults, therapists can guide their clients toward positive adaptive patterns.

The research serves as a keystone for further exploration into how psychological strategies can affect the occupational engagement and quality of life for older adults with ARVL. It also sets a precedent for developing comprehensive intervention programs that acknowledge the psychological aspects of adapting to vision loss, alongside the physical and practical adjustments.

In addition to the practical implications, this study invites society to recognize the often-ignored struggles of the elderly with vision impairments and to promote accessible environments that accommodate their needs.


1. McGrath, C.E., & Corrado, A.M. (2020). Adaptations to support occupational engagement with age-related vision loss: A metasynthesis study. Canadian Journal of Occupational Therapy, 86(5), 377-387. doi:10.1177/0008417419834422
2. Lam, N., Leat, S.J. (2013). Barriers to accessing low-vision care: the patient’s perspective. Canadian Journal of Ophthalmology. 48(6), 458-462. DOI:10.1016/j.jcjo.2013.05.013
3. Schilling, O.K., Wahl, H.W., Horowitz, A., et al. (2011). The adaptation dynamics of chronic functional impairments: What we can learn from older adults with vision loss. Psychology and Aging, 26(1), 203-213. DOI:10.1037/a0021132
4. Crews, J.E., Campbell, V.A. (2004). Vision impairment and hearing loss among community-dwelling older Americans: Implications for health and functioning. American Journal of Public Health, 94(5), 823-829. DOI:10.2105/AJPH.94.5.823
5. Wahl, H.W., Heyl, V. (2003). Connections between vision, hearing, and cognitive function in old age. Generations, 27(1), 39-45.


1. Age-related vision loss
2. Occupational therapy for ARVL
3. Psychological adaptation strategies
4. Coping with vision impairment
5. Elderly occupational engagement