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Background: To examine the association between accelerometer-assessed physical activity and visual acuity among a nationally representative sample of adults with evidence of diabetes., Methods: Six hundred seventy adult participants with diabetes (age 20 to 85) from the 2003-2006 NHANES cycles constituted the analyzed sample. Participants wore an accelerometer for 7 days to quantify time spent in sedentary behavior, light-intensity physical activity and moderate-to-vigorous physical activity. Visual acuity was objectively assessed for each eye., Results: In multivariable models, every 1-hour increment in daily sedentary behavior was associated with 23% greater likelihood (OR = 1.23; 95% CI: 1.01-1.52) of having uncorrected refractive error as opposed to normal sight. Performing more than 5 minutes of daily moderate-to-vigorous physical activity was associated with a 82% lower likelihood of having vision impairment as opposed to normal sight (OR = 0.18; 95% CI: 0.06-0.50) while every 1-hour increment in daily light-intensity physical activity was, after adjustments, independently associated with a 38% lower likelihood of vision impairment (OR = 0.62; 95% CI: 0.42-0.92)., Conclusion: People with diabetes spending more time in sedentary behavior and less time performing light or moderate-to-vigorous physical activity are more likely to have poorer vision.