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Purpose To determined the causes of visual impairment among patients seeking ophthalmic treatment, in secondary and tertiary level outpatients clinics, in Brazil. Methods The authors and the Collaborating Groups recorded the main complaints and diagnoses of all the new cases attended at 29 services that maintain Courses of Specialization in Ophthalmology accredited by the Brazilian Council of Ophthalmology (CBO) during a typical week for each one of them. Results Twenty‐nine centers from ten states in the five regions of the country participated, with a total 3,997 new cases registered and included in the study. Median patient age was 49 years and 42.9% were males. The most frequent complaint (50.1%) was gradual/chronic reduction of visual acuity. The frequency of visual deficiency (low vision and blindness) was 20,3%, and the main causes were Cataract (34.7%), Diseases of the retina (18.0%), Glaucoma (8.0%), Diseases of the Cornea (7.3%), Diseases of the Conjunctiva (5.3%) and non‐corrected Refractive Errors (4.9%). The bilateral blindness rate, among the 3,997 participants, was 3.10% and the main determinants were Cataract(36.3%), Diseases of the Retina (25.0%) and Glaucoma (6.5%). Conclusion As expected, the frequency of visual impairment in patients seeking eye care was higher than in general population, of regions with similar level of development. The study provided indicators for the establishment of ocular health actions and for the prevention of blindness in Brazil. [ABSTRACT FROM AUTHOR]