End Stage Renal Disease (ESRD) is stage 5 of chronic kidney disease with GFR < 15 ml/minute.Objectives: To measure the prevalence of ocular involvement in ESRDin a tertiary care center in South India.

Methods: Cross sectional observational study of 200 eyes of 100 ESRD patients.Inclusion Criteria: ESRD patients aged ≥ 18 years. Exclusion Criteria: Patients with preexisting ocular diseases. Detailed ophthalmic examination and statistical analysis were done.Results: Mean age 56.15 ±11.47 years. M: F 3.5:1.  90% prevalence of ocular changes in patients with ESRD.67% had cataract, 79% had hypertensive retinopathy, 57% had diabetic retinopathy and 38% had macular edema.Discussion: Hypertensive retinopathy was the commonest ocular manifestation and cataract was the commonest cause of defective vision. Irreversible loss of vision was due to diabetic retinopathy aggravated by ESRD.Conclusion: This shows the need for detailed ophthalmic examination even in asymptomatic ESRD patients.