Purpose: To evaluate the causes of visual impairment in adults attending our Government tertiary care hospital, in India for the purpose of blindness disability certification to aid in better planning and prevention of blindness activities in India. Methods: The study was a non-interventional cross-sectional record-based analysis on 411 adults with permanent visual impairment attending Ophthalmologyout patient department of Mandya Institute of Medical Sciences, Mandya, India for blindness disability certification during July 2019 to Dec 2020. Patients demographic data, educational background, need for disability certification and area of residence all noted after complete ocular examination and categorised depending on the etiology and percentage of visual impairment. Groups analyses and P<0.05 was taken as level of statistical significance. Results: Of the 411 subjects, 65.2% were males and the majority >53% were in the 18-39 years age group. Overall, most frequent cause of permanent visual impairment was congenital anomalies (17.7%) and retinitis pigmentosa (17.03%). However, age group based data showed a trauma (59.09%) was the most common cause for 30% visual impairment (one eyed). Most common causes for ‘low vision’ and ‘blindness’ in the study group was amblyopia (19.01%) and Congenital anomalies (29.9%) respectively. Conclusion: Congenital anomalies and retinitis pigmentosa were common cause of visual impairment in our study, hence proper genetic counselling to expectant mothers can mitigate these. Early & timely regular school screening activities by authorities can help control the incidence of amblyopia and high refractive errors. Policymakers should at regular intervals form consensus based on disability data to better manage and empower the blind and mitigate the prevalence of ocular morbidity.