Two hundred children from one neonatal intensive care unit (NICU), who were very low birthweight (VLBW), were examined at approximately 9 years of age and compared with a control group of normal birthweight children. Visual morbidity was significantly higher among children who were very low birthweight. Binocular visual acuity of 6/9 or worse was noted in 21 (10.5%), strabismus in 38 (19%) and regressed retinopathy of prematurity (ROP) in 13 (6.7%) of these children. A history of seizures in the perinatal period was highly correlated with poor visual acuity. Independently significant factors associated with strabismus included clinically diagnosed intraventricular haemorrhage, a maternal history of neonatal death, transfer from another hospital, bronchopulmonary dysplasia and necrotising enterocolitis. Perinatal variables that correlated with regressed ROP included birthweight, time from birth to admission to the NICU, necrotising enterocolitis and a history of maternal smoking during the pregnancy. When screening for ocular abnormalities among children who were born preterm, particular attention should be given to children with these risk factors.