Background: The aim of the study is to identify Gender and Anatomical Influences on the prevalence of Low vision and Blindness in Owerri, Nigeria. Methods: A total of 12,160 subjects comprising 4230 males and 7930 females who met the inclusion criteria were seen between January 2005 and December 2019 from Eye clinic attendees in Owerri, Imo State, Nigeria. Visual impairment was defined as Visual Acuity <6/18. All the subjects underwent a complete ophthalmic examination. Standard procedures were used to determine visual parameters of subjects Results: Subjects with low vision in both eyes were in the majoity (70.8%). Subjects with low vision in the left eye only (15.7%) were more than those with low vision in the right eye only (13.5%). There were more females (54.7%) with low vision than males (45.3%). Those aged ≥ 50 years (66.3%) were in the majority among subjects with low vision. Subjects blind in both eyes were 4.1%. Those with blindness in the left eye only (56.2%) were more than those with blindness in the right eye only (39.7%). There were more males (58.3%) than females (41.7%) among those who were blind. Those aged 50 years and above (73.1%) were in the majority among subjects who were blind. Conclusions: Our findings has provided evidence that low vision and blindness are more prevalent in the left eye than in the right eye. In addition, there were gender differences in the prevalence of low vision and blindness, with more females with low vision; and more males with blindness. There is a need to take these observations into consideration in the management of visual health.