Visual impairment accompanies a wide range of ocular and systemic diseases and is a common cause of disability in the United States (US). It has been estimated that about 10 million people in the US are visually impaired. The World Health Organization (WHO) estimates that 314 million people worldwide are visually impaired and that 45 million of them are blind. These estimates are based for the most part on high contrast acuity. Common factors associated with visual impairment, some predisposing to impairment, other than the result of impairment, are age, potential to contribute to the work force, their quality of life, depression, and the possible effect of poor vision on independence and cognition.The economic burden of major adult visual disorder in the US was estimated to be 35.4 billion dollars annually, including 16.2 billion dollars in medical costs, 11.1 billion dollars in other direct costs, and 8 billion dollars in productivity losses. This is a transnational problem. For example, the economic cost of visual impairment in Japan was estimated to be 72.8 billion dollars in 2007. While assistive equipment exists to compensate for some of the disabilities, they do not restore vision and costs may be more than individuals and health care systems can afford. Thus, visual impairment is common and is a costly burden for individuals and for health care systems.Visual impairment associated with aging accompanies a wide range of ocular and systemic diseases including age related cataracts, age related macular degeneration diabetic retinopathy, retinal vein occlusions and refractive error. Therefore, information is given speci fi c to these entities.