BACKGROUND Eye disorders in children with different presentations come to Ophthalmology OPD. Early detection and treatment of ocular morbidity is important. This study aimed to detect the prevalence and pattern of common ophthalmic problems in paediatric age group, in a rural based tertiary care hospital. MATERIALS AND METHODS Study design was observational, retrospective review of all children less than 12 yrs. old, who came to the rural based Chengalpattu Government medical college Ophthalmology OPD, between September 2015 and May 2016. Data collection and analysis was based on the age of presentation of both sexes (newborn (0-28 days), infants (1 year), preschool (1-5 years), school going (above 5 years)) from rural and semi-rural areas and diagnosis were analysed using graph pad prism 5.0. 'P value' less than 0.05 was considered statistically significant. RESULTS During the study period, out of total 2520 OP cases (100%), 230 children (10.95%) were evaluated. The male: Female ratio was 1.1:1. The children from school going age constituted the largest group, male (48 .4%) & Female (51.5%) (p<0.001). Children from semi-rural area constituted (55%) and rural area constituted (45%). Defective vision (26%) was the common complaint, eye discharge accounts for (20%), and lid swelling accounts for (11.3 %). Common conditions were refractive error (26%), Conjunctivitis (20%), Lid Inflammations (11.3%), and Injuries for (10.3%). Refractive Error was common in females (53.3%) and in school going children (60 %). Myopia (85%) was the common refractive error. Conjunctivitis was seen more in males (52.17%) and less in females (47.8%). In preschool age group conjunctivitis was common. CONCLUSION The common childhood eye diseases observed in our study is refractive error. This has led to poor scholastic performance in school and absenteeism. Health Education & Environmental Hygiene will help in managing most of these eye disorders.