Visual impairment among the elderly is a major health problem. With advancing age, the normal function of eye tissues decreases and there is an increased incidence of ocular pathology. Demographic studies have shown that age is the best predictor of blindness and visual impairment. The most common causes of age related visual impairment in the elderly are presbyopia, cataracts, age related macular degeneration, primary open angle glaucoma and diabetic retinopathy. Untreated visual impairment leads to physical handicap, increased incidence of fall, depression, social isolation and dependency. Active screening for visual loss in the elderly should be part of the health examination. The elderly should be encouraged to come for formal 1-2 yearly eye assessment for early detection of visual impairment and to treat all associated problems in order to prevent permanent visual loss.