A study of 113 blind people in Mansoura, Egypt highlighted the causes and risk factors for blindness, and health and social care needs of the blind. In two-thirds of cases, blindness occurred before 10 years of age. Risk factors for blindness were reported by more than half the study population. Congenital causes accounted for almost half the cases. The commonest causes of bilateral blindness were corneal opacities, cataract and glaucoma. Almost three-quarters of causes were avoidable. Health and social care for this group was inadequate and more than half would benefit from further management. Legislation for keratoplasty, a registry of blind people, and a nationwide community survey on the epidemiology of blindness are needed urgently.