Visual acuity was measured and cataract recorded in a simple random sample of 215 men and 272 women aged 63–90 years in Edinburgh. One year and five years later the observations were repeated in 113 men and 148 women surviving and available from the original sample. This paper deals with survivors only.Worsening of visual acuity occurred over five years in 12of men and 14of women. Improvement was noted in 15of men and 10of women. The proportion of those with worsening of visual acuity increased significantly with increasing age at entry to the study. Assessments made by subjects of visual change in five years proved inaccurate when checked by measurement.Prevalence of cataract rose from 15at the original examination to between 36and 46after five years. Increases in prevalence of cataract were greater in older subjects.If cataract was present at any examination, visual acuity worsened in five years in 24of subjects compared with 11without cataract at any examination. The proportion of persons with cataract and vision worse than 6/12 was 76of 37 persons at the original examination and 66of 105 after five years. Corresponding figures in those without cataract were 37of 223 and 36of 155. The actual number with poorer vision associated with cataract more than doubled in five year
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