Cross-sectional surveys for the prevalence of blindness in West African savanna villages misrepresent the actual burden which blindness imposes on communities. High mortality in the blind, resulting in a shorter life expectancy as compared to non-blind, is associated with high incidence rates and with a rapid turn-over in the blind population. Data collected in Burkina Faso indicate that, in hyperendemic villages, 46% of males and 35% of females aged 15 are likely to become blind before they die. Respective rates in mesoendemic villages are 14% in males and 9.8% in females. The results presented in this paper reinforce the conclusion that blindness, especially onchocerciasis associated blindness, is of greater social and economic significance than usually estimated.