AIM: To determine the prevalence of ocular involvement and pattern of ocular morbidity in leprosy patients. METHODS: Leprosy patients were examined in their respective treatment centers by the ophthalmologist over a period of three years. After recording visual acuity, anterior segment was examined with torch light and magnifying loupe. Intraocular pressure was measured with Schiotz tonometer. Fundus was examined, after dilating pupils with tropicamide eye drops, with direct ophthalmoscope. RESULTS: Out of 1 004 patients examined, 530 were suffering from lepromatous leprosy, 413 from tuberculoid leprosy, 61 from borderline leprosy. Ocular lesions related to leprosy were noted in 606 (60.3%) patients. Corneal changes (81.1%) were the most frequently observed lesions followed by eyelid changes (42.1%). Potentially sight threatening lesions such as lagophthalmos (17.3%), corneal anaesthesia (36.1%), and iridocyclitis (14.7%) were seen in these patients. None of the patients showed any fundus changes related to leprosy. Cataract, not related to systemic disease, was noted in 177 (17.6%) leprosy patients. Blindness related to leprosy was seen in 169 (16.8%) patients; chronic iridocyclitis with its complications was the most common cause of blindness in these patients. CONCLUSION: Ocular involvement was seen in 60.3% of leprosy patients; corneal lesions being the most common. One or more potentially sight threatening lesions were seen in two-thirds of these patients. Blindness related to leprosy was seen in 16.8% of patients. Early referral of patients with eye problems and treatment of potentially sight threatening lesions and cataract will reduce the prevalence of blindness in leprosy patients.