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Background: The prevalence of vision impairment,unilateral/bilateral blindness,and cataract surgery were estimated in a population based survey among the elderly in a suburban area of Hong Kong.Methods: 15 public,private,and home ownership scheme housing estates in the Shatin area of Hong Kong were subjected to cluster sampling to randomly select a cross section of people 60 years of age or older.Visual acuity measurements and ocular examinations were conducted at a community site within each estate.The principal cause of reduced vision was identified for eyes with presenting visual acuity worse than 6/18.Results: A total of 3441 subjects from an enumerated population of 4487 (76.7%) completed an eye examination.The prevalence of presenting visual acuity less than 6/18 in at least one eye was 41.3%; and 73.1% in those 80 years of age or older.Unilateral blindness (acuity <6/60) was found in 7.9% of subjects and bilateral blindness in 1.8%.Refractive error and cataract were,respectively,the main causes of vision impairment and blindness.Visual impairment with either eye <6/18 increased with advancing age and was more prevalent in males,the less educated,and those living in public housing estates.The prevalence of cataract surgery was 9.1% and was associated with advancing age and less education.Conclusions: Blindness and visual disability were common in this socioeconomically advanced population,with most of it easily remedied.Because of a rapidly ageing population,healthcare planners in Hong Kong must prepare for an increasing burden of visual disability and blindness.