OBJECTIVES To examine the economic impact and independent determinants of visual impairment (VI) in Singapore METHODS RESULTS The median (range) age of participants was 73.0 years old (47.0-92.0). The proportion of male was 48.0% and the median (range) presenting VA was 0.54 (0.30-2.00). The yearly median (range) MC and LP were S$1.53K (S$0.13-S$83.59K) and S$0 (S$0-S$7.62K) per person, respectively. The yearly MC for those with mild VI (S$3.50K) was significantly lower than those with moderate/severe VI (S$5.21K) (P<0.0001). The yearly MC in participants reporting full health or better vision function were lower than those not in full health or better vision function (e.g. MC for participants in full health=S$2.96K; MC for participants not in full health=S$5.19K; P<0.0001). After adjusting for socio-demographic characteristics, the association between MC and VI, EQ-5D and VF-14 remained the same. LP had a similar association with EQ-5D and VF-14 with or without adjustment; however, LP decreased with VI severity (the adjusted difference in LP between participants with mild and moderate/severe VI=S$0.22K, P=0.3846). CONCLUSIONS Visual impairment poses substantial economic burden on individuals and families in Singapore. The economic burden of VI is mainly medical costs. Self-reported health problems seem to be better predictors of costs of VI than clinical measures.