Background: Fifty-three patients who had been attacked with acid were treated over the last three years, and 45% suffered blindness in one or both eyes as a result. Objective: Review the charts of all 53 patients to see if the proximate cause of the blindness could be determined to prevent it happening to others. Results: Three principal causes of blindness were direct damage from acid, limbal stem cell loss leading to later eyeball perforation, and delayed corneal abrasion from eyelid deformity. Only the latter cause could be prevented at this time, since the strength of the acid used in the attack could not be controlled, nor could limbal stem cell transplants be performed. Conclusion: Assessment of the ophthalmic injuries revealed three main categories of visual impairment, only one of which could be treated effectively at this stage.