Introduction: Visual impairment is common in older people, and is a risk factor for falls and hip fractures, reduced independence and quality of life. Objectives: To assess the prevalence and causes of visual impairment in an aged care ward, and to evaluate whether routine eye assessment, and referral to an eye specialist was worthwhile to detect patients with low vision that could be correctable. Method: Clinical eye examination of 100 consecutive inpatients and review of medical records. Patients with a new diagnosis of visual impairment were referred for ophthalmology or optometry assessment. Results: The prevalence of low vision was 36% and the prevalence of blindness was 9%. There were 18 patients referred for specialist review, three patients were recommended a new treatment but only two received treatment. Conclusion: Visual impairment was prevalent. Although refractive error and cataracts were common, in only a few cases did detection and specialist referral lead to improved visual outcomes.