This article details the changing trends in the major causes of blindness and visual impairment in Singapore over the past four decades. A comprehensive review of existing data from published and unpublished sources on ocular disease studies and surveys in Singapore was conducted. The rates of blindness and visual impairment from cataract, age-related macular degeneration, glaucoma, diabetic retinopathy and refractive errors, as well as other major diseases are described and compared with other Asian countries. Such epidemiological data on the blinding conditions in our population are vital in the understanding of trends in ocular diseases, as well as in prioritizing current health services and preventive programmes.