A world-wide study on the ocular complications of leprosy has been carried out over the past ten years. The data from 4772 patients, designed to give baseline information for a five-year incidence study, have been analysed. Blindness due to leprosy was seen in 3.2% of the sample and 7.1% had Grade 2 visual disability. The causes of visual impairment in the disease are discussed and it is emphasized that a high proportion of these are preventable, particularly through the early use of multidrug therapy. The active participation of ophthalmologists in the management of the disease is still required since many of the blinding complications respond well to surgery.