Fenwick EK, et al. - An inspection was carried out of the direct and indirect effect of restrictions in daily living activities on the association between perceived visual symptoms linked to diabetic retinopathy (DR) and psychological functioning. The vision and psychological functioning outcomes such as emotional distress and concern correlations were complex in patients with DR. They appeared to be mediated by limitations in daily living activities and social factors. Interventions to enhance daily functioning and social interaction could be effective in lowering the emotional distress linked to DR-related vision impairment.