In a population-based survey performed on the middle-aged and elderly population of Casteldaccia, Sicily, we found that the prevalence of blindness was 0.47% and the prevalence of low vision 1.22%. Unilateral blindness affected 2.81% of the population and unilateral low vision 4.12%. Visual impairment was much more frequently seen in subjects aged 70 years or more than in younger persons. The main cause of visual impairment was cataract, followed by amblyopia, which was responsible for many cases of unilateral low vision.