Background/aims  A survey was undertaken to assess the prevalence and causes of blindness and visual impairment in people aged ≥50 years in 3 different counties in Jiangxi (Gao’an, Xin’gan, and Wan’zai), one of the poorest provinces in South East China in 2007.

Methods  Clusters of 50 people aged ≥50 years were sampled with probability proportional to the size of the population. The total sample size was 4,699 in Gao’an (94.0% response rate), 3834 in Xin’gan (95.9%) and 2861 (95.4%) in Wan’zai, , as the total population in these three counties are 782,041, 286,348 and 485,330 separately. Households within clusters were selected through random walk sampling. Visual acuity (VA) was measured with a tumbling “E” chart. Ophthalmologists examined people with VA<6/18 in either eye.

Results  The prevalence of blindness was similar in Gao’an (1.5%, 95% CI: 1.1% - 1.8%), Xin’gan (1.8%, 1.4% - 2.2%), and Wan’zai (1.6%, 1.2% - 2.1%), and the prevalence of visual impairment was approximately four-fold higher. Cataract was the leading cause of blindness in each of the three counties, while refractive error was the dominant cause of visual impairment. The majority of blindness was avoidable in Gao’an (84.3%), Xin’gan (71.0%) and Wan’zai (71.7%).
Conclusions  The prevalence of blindness in the three counties in Jiangxi, China was lower than expected, yet most of the blindness and visual impairment was avoidable, indicating that the prevalence could be reduced further through adequate program planning and implementation.