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Introduction Vision impairment (VI), multimorbidity and disabilities are common among older populations. Although the prevalence of VI and its associations are frequently reported, the incidence and risk factors are not well documented in India. The Longitudinal Eye Health, Ageing and Disability Study (LEADS) aims to: (a) determine the prevalence, causes, risk factors and impact of VI; (b) explore the associations between VI and sociodemographic risk factors, systemic health conditions (multimorbidity), physical performance, hearing, depression, social connectedness and cognitive function; and (c) evaluate the impact of eye interventions such as cataract surgery and refractive correction (for distance and near) on these conditions. Additionally, (d) to assess the annual incidence of and risk factors for VI among older people in the community.Methods and analysis Individuals aged ≥60 years are selected from seven districts across three regions in the states of Andhra Pradesh and Telangana in Southern India. A two-stage cluster random sampling method is used to enrol participants. Trained field investigators administered a set of questionnaires, including personal and sociodemographic information, ocular and systemic history, cognition, depression, hearing, falls and fear of falling. The Short Physical Performance Battery is used to assess physical performance. A comprehensive eye examination is conducted in makeshift clinics set up nearby. The examination included unaided and aided visual acuity for distance and near, using minimum logarithm of resolution charts, manual and auto refraction, slit lamp biomicroscopy and anterior and posterior segment imaging using a non-mydriatic fundus camera. The individuals will be examined at baseline (wave I) and then at a follow-up visit planned after 18–24 months (wave II).