OBJECTIVE To determine the pattern of visual impairment and blindness in patients seen at a hospital in North Central Nigeria. METHODS All new eye patients seen at Adoose Specialist Hospital, Jos, North Central Nigeria with conditions potentially leading to blindness and visual impairment over a ten year period were studied.The patients' demographic information, diagnosis and visual acuity were retrieved from the records. RESULTS A total of 2536 patients were reviewed. There were 1315 (51.9%) males. Bilateral blindness was seen in 279 (11.0%) of the patients. Visual impairment was seen in 745 (29.4%) patients. Severe visual impairment (SVI) was seen in 4(0.2%), moderate (MoVI) in 225 (8.9%) and mild (MVI) in 237(9.3%). Blindness and visual impairment increased significantly with age. Blindness was most prevalent among the farmers (40.2%), followed by the house wives (24.4%). It was attributable to refractive error in 33.3%, cataract in 28.3%, glaucoma in 13.3%, posterior segment disease in 8.2%, glaucoma/cataract in 7.9%, cataract/posterior segment disease in 1.8%, trauma and uveitis each in 1.4%, with other ocular conditions (affecting the globe) seen in 1.1% and corneal disorders in 0.7%. Proportionately more males had glaucoma, trauma, corneal disorders and posterior segment disease, while females predominated with refractive error, conjunctivitis and cataract. CONCLUSIONS Refractive error, cataract and glaucoma were the major causes of blindness, underpinning the significance of these conditions in ocular morbidity.