BACKGROUND: Two-hundred one adults age 65 and older underwent vision screening at community senior centers and nutrition sites in the Birmingham, Alabama metropolitan area. METHODS: Using a multiple-test format recommended by the American Optometric Association, 89 percent of those screened failed. Reduction in visual acuity associated with anterior segment abnormalities was the most common reason for failure. Almost half (48 percent) of the overall population had less than 20/50 distance acuity in both eyes. Median visual acuity for the population was 20/50. Median visual acuity decreased with age from 20/40 at age 65 to 20/80 for those over the age of 85, while only 8 percent were legally blind. RESULTS: Results show that a large percentage of older adults have reduced vision without being legally blind and will fail vision screening. CONCLUSIONS: Given the high failure rate, the value of this type of vision screening is questionable.