Visual impairment and poor eye health is frequently ignored in care homes impacting on quality of life and independence for older people.This evidence review, published with the support of Thomas Pocklington Trust, examines the current situation in care homes in England, reviewing current practice of sight testing and the regulatory and legislative context of eye health. It highlights that existing policy does not explicitly promote eye health, and how combined with low awareness of sight loss, this has led to poor levels of the detection of eye problems in care home residents.