## 4 Discussion
\begin{table}
\begin{tabular}{c c c c c c c} \hline \hline \multicolumn{5}{c}{**Scoring Time (s)**} & \multirow{2}{*}{\(p\)} & \multirow{2}{*}{**F**} & \multirow{2}{*}{**Post-Hoc**} & \multirow{2}{*}{**N**} \\ \cline{1-1}
**UCVA 1** & & & & & & \\ \hline
121.73 \(\pm\) 47.08  & 125.05 \(\pm\) 46.10  & 103.78 \(\pm\) 33.37  & 0.01 & 5.44 & b \(<\) c & 19 \\ \hline \hline \end{tabular}  
Data are expressed as mean \(\pm\) SD; \(p\)-value for repeated measure ANOVA; Analyzed using repeated measures ANOVA; [ENDFOOTNOTE]  
subgroup by [PERSON] post-hoc analysis; 1 Uncorrected visual acuity (UCVA); 2 Distance-corrected visual acuity (DCVA); 3 Near-corrected visual acuity (NCVA).  
\end{table} 
Table 3: The time spent for completion the apple cancellation test sheet under three different conditions for correction of visual acuity. uncontrolled state with the ciliary muscle in a relaxed state. Although most of the subjects in this study had degenerative hyperopia refractive error (OD: mean Sphere + 0.69 \(\pm\) 1.18, Cylinder \(-\) 0.75 \(\pm\) 0.66, OS: mean Sphere + 0.48 \(\pm\) 2.24, Cylinder \(-\) 0.68 \(\pm\) 0.73 D), the degree of their refractive errors was not so severe, so they did not wear glasses for distance correction. Uncorrected farsightedness can lead to problems such as decreased comprehension ability [24], decreased reading ability [25], and poor visual perception and attention [26]. However, the use of an appropriate optical correction that can improve not only distance visual acuity but also near visual acuity can enhance reading speed [27]. Compared with no vision correction, the use of the glasses that were provided to the participants in this study for the correction of distance visual acuity resulted in an increase in the number of correct responses and a reduction in the time spent completing the apple cancellation test. Accordingly, the proportion of participants who were diagnosed with positive UN decreased; however, the effect was marginal when compared with the results for glasses for the correction of near visual acuity. Presbyopia, an age-related change in the eyes that usually occurs around the age of 45, is characterized by a decrease in the physiological function of the crystalline lens and ciliary muscles, leading to a decline in near vision; thus, it can cause inconveniences during the performance of close-range work in daily life [28]. In addition, continuous age increase is accompanied by the deterioration of visual acuity [29] and cognitive decline [30]. Therefore, the authors provided specific guidelines for visual correction conditions, with consideration for the age of the subjects, prior to performing various tests that require conducting examinations at a close range. In particular, considering that the apple cancellation test used in this study is performed at close range and that the average age of the study participants was 73 years old, appropriate visual correction should be achieved by wearing near-vision glasses that are prescribed with the addition of presbyopia. We believe that the clinical implications of our study are significant, as it is the first interdisciplinary study attempting to analyze the effect of visual correction conditions on various pen-and-paper tests performed in the physical therapy and occupational therapy fields. In summary, the results of the apple cancellation test for the determination of UN varied depending on the conditions for the correction of visual acuity. Although wearing glasses for the correction of distance visual acuity alone resulted in a reduction in the overall frequency of subjects diagnosed with positive UN compared with the pre-correction and an increase in the number of correct responses with regard to apple shapes, specific guidelines for the correction of visual acuity required during the test should be provided.