To establish the prevalence and causes of low vision and blindness in children aged 0 to 15 years in Fiji using existing data and new surveys. Method: Childhood visual impairment data on both low visual acuity (Ͻ20/60-20/400) and blindness (Ͻ20/ 400) were obtained from existing records at hospital clinics, the school, an outreach service for visually impaired children, primary school screening records, and surveys in high schools and schools for children with multiple disabilities. Crude prevalence was derived and, using 5-year age range and age at onset of vision loss, the probable prevalence per 1000 children was calculated. Results: A total of 81 children were identified; causes were established for 70 children, showing that 69% had unavoidable causes of vision loss (retinal, 39.7% and corti-cal, 15.5%), with the avoidable cause of low vision and blindness mainly being cataract (15.5%). Probable prevalence was 1.134 per 1000 children (95% confidence interval [CI], 1.115-1.153), with low vision, 0.774 per 1000 children (95% CI, 0.758-0.790) and blindness, 0.36 per 1000 children (95% CI, 0.349-0.371). The rate of severe visual impairment (Ͻ20/ 200) was 0.522 per 1000 children (95% CI, 0.509-0.535), only half of the total vision loss. Conclusions: Both the low to moderate prevalence and mainly unavoidable causes of visual impairment indicated that Fiji, a developing country, has prevalence and causes of visual impairment similar to more resourced, industrialized countries.