Worldwide, visual impairment is increasing in prevalence: current data indicate that 284 million people have impaired vision,1 10% of whom live in the developed world. In the UK sight loss affects about two million people,2 including an estimated 80 000 of working age and 25 000 children. The prevalence of visual impairment is higher among those with multiple disability and older people.3 According to estimates from the UK’s Royal National Institute for the Blind (RNIB) one in 30 people of any age, one in five aged 75 or over, and half of those over age 90 years in the UK are living with sight loss.4 Older people with vision impairment report greater difficulty performing activities of everyday living than those with other or no sensory impairments.5 Individuals with impaired vision may have great difficulty in accessing and negotiating healthcare services. We discuss the difficulties that visually impaired patients encounter in the healthcare environment and ways in which problems may be overcome.