To examine differences in visual impairment between immigrants and natives in the United States (US).

This is a cross-sectional study of clinical vision examination data from the 2003–2008 National Health and Nutrition Examination Survey.

Analyses compare myopia, hyperopia, astigmatism, and visual acuity between noncitizens, naturalized citizens, and US natives. Visual acuity variables included having 20/40 or better corrected vision. Differences in 20/20 vision and legal blindness (20/200 or worse) were also examined. Respondents born in the United States were defined as US natives. Foreign-born respondents were categorized as either naturalized US citizens or noncitizen residents. Multivariate logistic regression of outcomes adjusted for sex, age, race/ethnicity, poverty, insurance, diabetes, and surgical correction for eyesight.

A smaller percentage of noncitizens than US natives had myopia (18.8% vs 30.7%) or astigmatism (22.0% vs 30.9%). However, noncitizens using corrective lenses had an adjusted odds ratio (AOR) of 0.65 of having 20/20 vision compared to US natives (95% confidence interval [CI] 0.48–0.88). Differences in visual acuity for 20/40 and better vision were not statistically significant for corrective lens users. Among nonusers of corrective lenses, noncitizens were significantly less likely than US natives to have 20/40 or better vision (AOR = 0.54; 95% CI 0.39–0.74). Noncitizens also had up to 3.5 times the odds of being legally blind relative to US natives after adjusting for confounding factors (95% CI 1.52–7.83).

Significant differences in visual acuity exist between immigrants and US natives. More research is necessary to identify underlying factors that may explain these disparities in visual impairment.