Objectives To determine detailed oculo-visual characteristics of children with intellectual disability studying in special schools and explore the burden of visual impairment.

Design of the study Detailed ophthalmic examination was carried out in all pupils studying at the seven special needs schools of Kathmandu valley, Nepal. Ophthalmic examination included case history, presenting distance visual acuity, cycloplegic refraction, binocular vision examination, contrast sensitivity and anterior and posterior segment evaluation.

Main outcome measures Ocular and visual status of children.

Results Refractive errors (40%) and strabismus (17%) were the commonest visual disorders in our study children. Ninety-five per cent of the children who had clinically significant refractive errors presented without any correction. Visual impairment was present in 25% of the children. Severe visual impairment or worse was present in 3% of the children. Other common ocular findings were conjunctivitis, blepharitis, chalazion and ectropion.

Conclusions High prevalence of preventable visual impairment in this population requires immediate attention. It is hoped that the formulation of proper vision care guidelines at a national level may help in early detection and management of visual disorders in this special population and enhance their quality of life.