Purpose : To assess perceptions and implications of COVID-19 across the spectrum of visual impairment (VI) and normally-sighted individuals Design : Prospective cross-sectional comparative study. Method : XXXXXX Setting : Institutional. Patients : 232 patients and their caregivers. Four groups were created based on better eye characteristics: blind (best-corrected distance visual acuity (BCDVA) < 3/60 or visual field < 10 central degrees), severe VI (3/60 ≤ BCDVA < 6/60, vertical cup-to-disc ratio ≥ 0.85 or neuroretinal rim width ≤ 0.1), moderate VI (6/60 ≤ BCDVA < 6/18), or no/mild VI (controls, BCDVA ≥ 6/18) based on International Classification of Diseases-10 criteria and Foster and Quigley's consensus definition of glaucoma. Procedure : Telephone questionnaires. Main Outcomes and Measures : Differences in perceptions and implications of COVID-19 across various levels of VI. Caregiver perceptions were a secondary outcome measure. Results : Survey was completed by 232 participants, with 58 participants in each VI group. Mean age was 58.9 years ± 13.2. Greater degrees of VI were associated with older age (P=0.008) and lower education level (P=0.046). Blind participants more commonly perceived vision as a risk factor for contracting COVID-19 (P=0.045), were concerned about access to healthcare (P<0.001), obtained news through word of mouth (P<0.001), and less commonly wore masks (P=0.003). Controls more commonly performed frequent handwashing (P=0.001), were aware of telemedicine (P=0.029), and had fewer concerns about social interactions (P=0.020) compared to groups with substantial VI. All caregivers reported more frequent patient care since COVID-19 began. Conclusions : The pandemic may have a disproportionate impact on the visually-impaired, and evidence-based assessments of COVID-19 health outcomes in this population are warranted.

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