Objective: To investigate the distribution characteristics of eye diseases and the prevalence and causes of blindness and low vision among adults aged ≥50 years in the communities of Hangzhou in China. Methods:This was a cross sectional investigation, clusters of randomly selected individuals of at least 50 years old
from some larger communities in Hangzhou China were sampled, and 2 953 individuals were enrolled.The selected participants underwent detailed ophthalmic examinations that included visual acuity,autorefraction, intraocular pressure, slit-lamp assessment of the anterior surface, direct ophthalmoscopy of posterior segment, and fundus photography. The prevalence and causes of blindness and moderate-to-severe visual impairment were calculated for subjects at different ages, sexes, and educational levels. The data were analyzed by the χ2 test. Results: From the enrolled individuals, 2 363 (80%) were examined. In this population, the prevalence of blindness and moderate-to-severe visual impairment was 1.6% (38 cases),and it increased with age ( χ 2 =38.094, P < 0.001). We also found that the lower the level of education, the higher the incidence of blindness ( χ 2 =39.497, P < 0.001). Retinal diseases (30 eyes, 39.5%), cataract (26 eyes, 34.2%), and glaucoma (12 eyes, 15.8%) were the leading causes of blindness and visual impairment. In addition, the prevalence of eye diseases in this population were uncorrected ametropia(2 048 cases, 86.7%), cataract (1 065 cases, 44.7%), pterygium (219 cases, 9.3%), age-related macular degeneration (81 cases, 3.5%), glaucoma (52 cases, 2.2%), strabismus (46 cases, 2.0%), and diabetic retinopathy (39 cases, 1.7%). Conclusions: The prevalence of blindness and moderate-to-severe visual impairment were low. The most common reasons for vision impairment of older adults aged 50 years or older in the Hangzhou communities were uncorrected refractive errors and cataracts. The leading causes of blindness and visual impairment were abnormal fundus and cataract.