Fifty-eight prematurely born children (gestational age < or = 32 weeks) were studied at the age of 5 years. The ophthalmological examination was part of an extensive neurodevelopmental evaluation. The eye study revealed significant hyperopia (> or = + 2.0) in 22.4%, myopia (> or = -1.0 D) in 8.6%, astigmatism (> or = 1.0 D) in 12.1%, and anisometropia (> or = 1.0 D) in 12.1%. The myopic refractive error was high in all of the cases: from -6.0 to -14.0 D. Manifest strabismus was found in 24.2% and significant visual impairment or blindness in 6.9%. Optic atrophy and cicatricial retinopathy of prematurity were the main causes for severe visual defects. In the randomly selected full-term children of the same age, significant hyperopia was seen in 14.3%, astigmatism in 5.4% and strabismus in 1.8%. The pattern of the eye findings was different in the preterm children compared with those born at term.