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Objectives: To determine whether regular eye examinations are associated with a greater or lesser rate of loss of ability to read newsprint, onset of blindness or low vision, or onset of limitations in instrumental activities of daily living (IADLs) and activities of daily living (ADLs). Design: A sample of 14,215 Medicare beneficiaries observed between 1994 and 1999 linked to the 1994 and 1999 National Long-Term Care Surveys (NLTCS). Effects of annual examinations were assessed using instrumental variables. Setting: The Medicare-linked NLTCS is representative of U.S. elderly persons from 1994 to 1999. Participants: Longitudinal observational study of persons aged 65 and older. Measurements: Change in self-reported and provider-reported vision and change in functional limitations associated with vision related to the number of years with eye examinations and other factors. Results: Persons with more-regular eye examinations between 1994 and 1998 were less likely to have experienced a decline in vision or in functional status between 1994 and 1999. On average, an additional year with an eye examination was associated with a decrease in the probability of becoming unable to read newsprint of 0.12 ( P=.03), a lower probability of onset of low vision or blindness of 0.009 ( P=.06), and a decrease in the probability that the number of functional limitations increased of 0.13 ( P=.002) for IADLs and 0.05 ( P=.003) for ADLs. Conclusion: Elderly persons who have regular eye examinations experience less decline in vision and functional status. [ABSTRACT FROM AUTHOR]