OBJECTIVES: To evaluate the effect of vision-enhancing interventions (cataract surgery or refractive error correction) on physical function and cognitive status in nursing home residents. DESIGN: Longitudinal cohort study. SETTING: Seventeen nursing homes in Birmingham, Alabama. PARTICIPANTS: A total of 187 English-speaking adults aged 55 and older. INTERVENTION: Participants took part in one of two vision-enhancing interventions: cataract surgery or refractive error correction. Each group was compared against a control group (persons eligible for but who declined cataract surgery or who received delayed correction of refractive error). MEASUREMENTS: Physical function (ability to perform activities of daily living and mobility) was assessed using a series of self-report and certified nursing assistant ratings at baseline and at 2 months for the refractive error correction group and at 4 months for the cataract surgery group. The Mini Mental State Examination was also administered. RESULTS: No significant differences existed within or between groups from baseline to follow-up on any of the measures of physical function. Mental status scores significantly declined from baseline to follow-up for the immediate (P=.05) and delayed (P<.02) refractive error correction groups and for the cataract surgery control group (P=.05). CONCLUSION: Vision-enhancing interventions did not lead to short-term improvements in physical functioning or cognitive status in this sample of elderly nursing home residents. © 2009, Copyright the Authors.