PURPOSE: To determine the prevalence of visual impairment (VI) in populations 65 year or older from six European countries and describe the association with vision-related quality of life. VI was defined according to WHO as best corrected visual acuity <6/18/log MAR >0,48 (World Health Organization (1992): International Statistical Classification of Diseases and Related Health Problems, 10th revised ed. Vol 1. Geneva).METHODS: 4166 participants in The European Eye study, 65 years and older selected randomly from the general census in the participating centres, were interviewed for vision-related quality of life and underwent an eye exam including distance visual acuity, refraction and fundus photography.RESULTS: The prevalence of VI rose with increasing age and more so in women. There was a pattern of a higher prevalence of VI in the Mediterranean countries compared to Northern European countries with the exception of Tallinn (Estonia) which had higher VI prevalence rates than the other north European centres. The prevalence of low vision was 3% or less in all centres. Blindness prevalence varied from 2% to less than half a per cent. Vision-related quality of life was strongly associated with visual acuity and the presence of bilateral age-related macular degeneration.CONCLUSION: The prevalence of visual impairment in the examined ageing European populations shows a definite increasing trend from north to south.