Objective: To determine the prevalence of mild visual impairment (MVI) among urban older adults in primary care settings, and ascertain whether MVI was a risk factor for inadequate performance on self-care health tasks. Method: We used data from a cohort of 900 older adults recruited from primary care clinics. Self-management skills were assessed using the Comprehensive Health Activities Scale, and vision with corrective lenses was assessed with the Snellen. We modeled visual acuity predicting health task performance with linear regression. Results: Normal vision was associated with better overall health task performance (p = .004). Individuals with normal vision were more likely to recall health information conveyed via multimedia (p = .02) and during a spoken encounter (p = .04), and were more accurate in dosing multi-drug regimens (p = .05). Discussion: MVI may challenge the performance of self-care behaviors. Health care systems and clinicians should consider even subtle detriments in visual acuity when designing health information, materials, and devices.