OBJECTIVES: To measure the burden of the disease and provide a basis for the healthcare policy decisions. METHODS: The analysis was performed based on the several data sources. Data on prevalence of bilateral blindness and visual impairment were obtained from the official Annual Report on the Ophthalmic Clinics Activities. Cost analysis was performed from the Health and Social Insurance perspective and reflects the real costs of healthcare payers in 2010. Information on healthcare and social expenditure were obtained from State Health and Social Insurance Funds. As detailed data on expenditures were not always available in a necessary structure, the missing data were collected in the retrospective patient survey. Both direct and indirect costs were evaluated and divided by the cost type and level of visual impairment. For the estimation of indirect costs Capital method was used. Patient survey was conducted on randomly collected geographically homogeneous sample of 89 respondents from all over Slovakia. RESULTS: A total of 17 201 persons with bilateral blindness or visual impairment were identified in 2010. Total yearly expenditures were 63 677 300 €. Direct costs counted only for 7% (4 468 112 €) of total costs and the most of them were caused by hospitalisations (4 001 539 €) and medical devices (307 739 €). The indirect costs counted for 59 209 188 €. The highest share represented loss of productivity (69%), followed by disability pensions (17%) and compensation of medical devices (14%). CONCLUSIONS: The evidence of cost-effectiveness must be demonstrated in order to get reimbursement in Slovakia. According the Slovak guidelines indirect costs are accepted only in exceptional cases. Indirect costs of blindness and visual impairment count more than two thirds of total costs and therefore should be considered in healthcare policy evaluations.