AIM: To evaluate the effects of refractive errors and binocular vision anomalies on the quality of life (QOL) of university students. METHODS: This cross-sectional analytical study was conducted on university students using simple random sampling. Objective refraction, ocular alignment, vergence and accommodative performance were measured and assessed in all participants. Data on QOL were collected using the College of Optometrists in Vision Development-Quality of Life (COVD-QOL) Questionnaire. The effect of mentioned parameters on the QOL were evaluated. RESULTS: Totally 726 students with mean age of 21.35±1.88y were evaluated in this study, 51.5% of whom were female. Esophoria was caused significantly lower QOL in the domains of somatic symptoms and occupational-physical symptoms (P<0.05); Besides, esotropia decreased QOL in domains of somatic symptoms P=0.002 and psychological factors (P=0.023). Students with accommodation insufficiency experienced more symptoms in all domains (P<0.05) except for psychological factors (P=0.07). Increasing in the near point of convergence and accommodation and decreases QOL and increasing accommodative facility increases QOL (all P<0.05). Myopia and astigmatism cause decrease in QOL (both P<0.05), but hyperopic students had better QOL in comparison with others (P<0.05). CONCLUSION: Screening programs and treatment of refractive errors and binocular vision anomalies, especially phoria and accommodative insufficiency, positively impact the QOL and academic achievements of university students.