Visual disability in individuals aged 50 years and over seeking services of the Royal Blind Society in the years 1984 to 1989, was studied with respect to changes in frequency of major causes together with age and sex of those affected. The results mirror statistics in the UK. Age-related macular degeneration (AMD) accounts for an increasing proportion of visual disability (34% in 1984 to 43% in 1989). Of particular interest was the frequency of disability attributed to cataract. While decreasing (24% in 1984 to 19% in 1989), cataract still represents a significant cause of potentially treatable disability. The authors conclude that there is a changing prevalence of visual disability caused mainly by an increase in AMD and a subgroup of patients attending for services who appear to have a potentially remediable disability. These conclusions affirm the need for close liaison between ophthalmological practitioners and agencies for the blind.