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Background HIV/AIDS is a global pandemic which affects all body parts including the eyes. Ocular lesions are varied and affect almost all parts of the eye. HIV-related ocular complications may result into visual impairment and even blindness which affects the quality of life of the patients. Objective: To determine the clinical ocular manifestations and the prevalence of visual impairment among adult HIV/AIDS patients attending Mbarara Regional Referral Hospital Immune Suppression syndrome (MRRH/ISS) clinic. Methods: This was a cross-sectional study done at Mbarara Regional Referral Hospital Immune Suppression syndrome (MRRH/ISS) clinic. Systematic random sampling was used to get participants who were ≥18 years. Participants¬í demographic data and medical history including the most recent CD4-count were recorded. Distance visual acuity for each participant was determined. The lids, anterior and posterior segments of the eyes were examined for any lesions. Objective and subjective refraction including near vision was done. Visual impairment was defined as presenting visual acuity that is worse than 6/18, in the better eye, with presenting optical correction, if any. Data were collected using standard optometric instruments and a questionnaire. Data were entered and analyzed using Microsoft Excel software packages and STATA version 12.0. Results; A total of 290 participants were interviewed and examined, average CD4 count was 480 cells/μL. All participants were taking co-trimoxazole prophylaxis, and 93.5% were on HAART. The prevalence of HIV-related ocular manifestations was 2.1%. These included; molluscum contagiosum (0.7%), toxoplasma scars (0.7%), Kaposi¬ís sarcoma (0.3%) and squamous cell carcinoma (0.3%). The prevalence of visual impairment was 1.4%.The causes of visual impairment were refractive errors, cataract, cornea scars, toxoplasma scars, macula scars, macula hole, glaucoma, cataract, pterygium, post uveitis and staphyloma. Conclusion: 1 The prevalence of HIV- related ocular conditions was low. 2 The prevalence of visual impairment was low

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