Aim: To investigate whether unilateral vision loss reduced any aspects of qual ity of life in comparison with normal vision and to compare its impact with that of bilateral vision loss. Methods: This study used cluster stratified random sa mple of 3271 urban participants recruited between 1992 and 1994 for the Melbourn e Visual Impairment Project. All predictors and outcomes were from the 5 year fo llow up examinations conducted in 1997-9. Results: There were 2530 participants who attended the follow up survey and had measurement of presenting visual acui ty. Both unilateral and bilateral vision loss were significantly associated with increased odds of having problems in visual functions including reading the tel ephone book, newspaper, watching television, and seeing faces. Non-correctable by refraction unilateral vision loss increased the odds of falling when away fro m home (OR=2.86, 95%CI 1.16 to 7.08), getting help with chores (OR=3.09, 95%CI 1.40 to 6.83), and becoming dependent (getting help with meals and chores) (OR =7.50, 95%CI 1.97 to 28.6). Non-correctable bilateral visual loss was associat ed with many activities of daily living except falling. Conclusions: Non-correc table unilateral vision loss was associated with issues of safety and independen t living while non-correctable bilateral vision loss was associated with nursin g home placement, emotional wellbeing, use of community services, and activities of daily living. Correctable or treatable vision loss should be detected and at tended to. Aim: To investigate whether unilateral vision loss reduced any aspects of quality of life in comparison with normal vision and to compare it whose impact with of of bilateral vision loss. Methods: This study used cluster stratified random sa mple of 3271 urban participants recruited between 1992 and 1994 for the Melbourn e Visual Impairment Project. All predictors and outcomes were from the 5 year fo llow up examinations conducted in 1997-9. Results: There were 2530 participants who attended the follow up survey and had measurement of presenting visual acui ty. Both unilateral and bilateral vision loss were significantly associated with increased odds of having problems in visual functions including reading the tel ephone book, newspaper, watching television, and seeing faces. Non-correctable by refraction unilateral vision loss increased the odds of falling when away fro m home (OR = 2.86, 95% CI 1.16 to 7.08), getting help with chores (OR = 3.09, 95% CI 1.40 to 6.83), and becoming dependent (OR = 7.50, 95% CI 1.97 to 28.6). Non-correctable bilateral visual loss was associat ed with many activities of daily living except falling. Conclusions: Non-correc table unilateral vision loss was associated with issues of safety and independen t living while non-correctable bilateral vision loss was associated with nursin g home placement, emotional wellbeing, use of community services, and activities of daily living. Correctable or treatable vision loss should be detected and at tended to.