Vision loss and blindness are potential complications of leprosy. There is little data available to indicate the impact of eye complications on life expectancy and quality of life. We sought to determine the relative risk of death in blind leprosy patients compared to nonblind leprosy patients. A population-based ocular survey of 510 mycobacteriologically negative leprosy patients in rural South Korea, conducted in 1988, formed the study population. After a 7-year period patients were traced to determine their status (alive, dead, lost to follow up). Blind patients showed a 4.8-fold risk of death, even after adjusting for other factors, compared to nonblind patients. Young blind leprosy patients had the highest relative risk of death. Excess mortality was not associated with any specific cause of blindness, ocular pathology, or type of disease. Findings from our study suggest that all leprosy patients with ocular disabilities (including those released from antileprosy treatment) should be targeted to receive eye care to prevent vision loss. Particular emphasis should be placed on young patients.