The causes of bilateral blindness (best visual acuity less than 3/60) in 1371 people in the Central African Republic seen between 1985 and 1989 who attended eye clinics in 10 out of the 16 prefectures across the country are given. The main causes of bilateral blindness were cataract (51%), glaucoma (12.7%), and onchocerciasis (8.1%). In 710 patients with unilateral blindness the main causes were cataract (38%), glaucoma (10%), iritis (7.5%), and trauma (6.3%). Bilateral blindness in children was rarely seen. The causes of visual impairment (vision between 6/18 and 3/60) in 424 patients were cataract, including aphakia (38%), maculopathy (14%), and onchocerciasis (7%).