A population-based, multistage random sampling survey on the prevalence and causes of blindness and visual impairment was carried out in Ikwerre Local Government Area of Rivers State between 8th September and 20th October 2007. Seven wards, 7 villages and various households were involved in the survey. The Data were recorded in the World Health Organization / Prevention of Blindness (WHO / PBL) eye examination form. Visual acuity was measured, basic eye examination carried out and intraocular pressure measured with Perkin’s applanation tonometer. Blindness and visual impairment were defined using WHO standards. A total of 1513 persons were examined consisting of 754 males and 759 females. The prevalence of bilateral blindness in this survey was 1.26% while that for bilateral Visual Impairment was 5.5% (4.1% for category I and 1.4% for category II) with a 95% confidence interval. The commonest causes of bilateral blindness were cataract (37%), glaucoma (31.5%) and optic atrophy (15.7%) while the leading causes of bilateral visual impairment were refractive error (50.6%) cataract (26.5%), glaucoma (8.5%), and optic atrophy (8.5%). There were more blind females (68%) compared to males (32%) which is statistically significant (P < 0.05) and they were all above 50 years old. Similarly, there were more females (52%) with bilateral visual impairment than males (48%), P > 0.05, most of whom were also over 50 years old. The prevalence of unilateral blindness was 1.7%, occurring more in males (54%) than in females (46%) and that for unilateral visual impairment was 6.7% also occurring more in males (64.4%) than females (35.6%). The main causes of unilateral blindness were cataract (42.3%), glaucoma (15.4%), optic atrophy (11.5%) and corneal opacity (11.5%) while the commonest causes of unilateral visual impairment were cataract and uncorrected aphakia (27.7%), optic atrophy (22.8%), refractive error (18.8%) and Chorioretinitis (12.9%). The burden of blindness can be reduced through effective planning and implementation of Programmes for Prevention of Blindness, outreach programmes, making cataract surgeries affordable, training of health personnel on basic eye care and establishment of a functional State Programme for Prevention of Blindness