This segment of a series of studies to ascertain the degree to which visually impaired persons use the Library of Congress National Library Service for the blind and physically handicapped (NLS) assesses the reading limitations of institutional residents and provides a basis for estimating the potential demand for print alternatives among such persons. It also presents a more general analysis of institutional settings which describes how institutional priorities, staff availability, space, services, and the design of settings influence the use of print alternatives. Chapters detail the methodology and background of the study, the nature of reading in institutional settings, the possession and use of the NLS services, implications of the findings, and the study's conclusions. A bibliography cites more than 80 sources, tables illustrate the data gathered, and appendices provide information on the survey sample, an example of a reading service record keeping system, and an index to case studies and personal profiles. (FM)