The U.S. population is aging, and occupational therapy practitioners working with older adults must have the skills to address multiple health issues, including vision loss. Although typical aging does not cause low vision, four major causes of vision impairment are directly related to the aging process: (1) age-related macular degeneration (AMD), (2) diabetic retinopathy, (3) glaucoma, and (4) cataracts. Instances of these impairments are expected to double by the year 2050, making low vision a significant public health issue. This Practice Guideline includes occupational therapy assessment and intervention guidelines for older adults who have visual acuity impairments, visual field impairments, or both as a result of a low vision diagnosis. Screening, referral, and evaluation are covered for clients for central visual field impairments, such as AMD and cataract; peripheral field impairments, such as glaucoma, hemianopsia, and quadrantanopsia; and mixed visual field loss, such as diabetic retinopathy. This work can help occupational therapists and occupational therapy assistants, as well as individuals who manage, reimburse, or set policy regarding occupational therapy services, understand the contribution of occupational therapy to treating older adults with low vision. Appendixes include selected diagnostic and billing codes and evidence tables.