We conducted 24 focus group discussions for parents and grandparents as part of a population-based survey of ocular morbidity to determine awareness and perceptions of eye diseases in children among parents and guardians of children in a rural south Indian population. Focus group discussions were conducted separately for mothers, fathers and grandparents. They were audiotaped and subsequently transcribed to the local language and English. Content analysis of the focus group discussions was done to identify key concepts, and this yielded five broad areas of interest relating to awareness and attitudes towards: 1) eye problems in children, 2) specific eye diseases in children, 3) vision problems in children, 4) existing health practices, and 5) utilization of services. Vision impairment did not figure in the top ten eye problems cited for children. There was a predominant belief that children below 4 years should not wear spectacles. Strabismus was considered as untreatable and was seen as a sign of good luck. Differing advice provided by the medical community for the same condition was an issue. The discussions also brought out that eye doctors were approached last for eye care, after traditional healers and general physicians. The discussions raise several issues of relevance that eye care programs need to address for better community involvement with programs. This will require a far greater focus than the current curative focus adopted by most programs.