Purpose:  To study the frequency of ocular abnormalities in developmentally delayed children of a private pediatric ophthalmology clinic. Study Design:  Observational cross-sectional. Place and Duration of Study:  Children eye care, Lahore, from October 2020 to October 2022. Methods:  Children aged five years and younger referred by a pediatrician for visual assessment were included in the study. The referring pediatrician made diagnosis of delayed milestones. A detailed ocular examination was done to rule out presence of any ocular abnormality. Data were collected, and statistical analysis was done using Excel (Microsoft 2015, version 15.15) and Stata (version 13). Results:  A total of 406 children were included in the study. Forty one percent were in the age bracket of 1 – 2 years. There were 63% boys. Among all, 77% had compromised vision, of which 60% had abnormal ocular findings, while cortical visual impairment (CVI) was seen in 17%. The most common ocular issue was refractive error (30.29%), of which hyperopia was seen in 70.7% and myopia in 29.3%. Strabismus was seen in 15.5% of children and exotropia being more prevalent. Visual delay was detected in 19.8%. Out of these 42% had hyperopia, whereas 21% had esotropia. Conclusion:  The significant association of ocular abnormalities with development delay is a cause of great concern as this can lead to an increase in overall morbidity. A timely examination by a pediatric ophthalmologist would lead to early detection of any ocular abnormality and convenient management, preventing undue visual impairment.