Objective: To assess ocular findings among patients with leprosy and ex-leprosy at Nazareth Leprosy Center. Methodology: An analytical cross sectional study was conducted at Nazareth Leprosy Center in Morogoro region, from June to December 2021.All patients with leprosy and ex-leprosy patients who were available at Nazareth during the study period were interviewed and examined. A total of 88 participants were enrolled in the study and their socio-demographics, clinical history and ocular examination findings were analysed. Results: There were 53 (60.2%) males and 38 (43.2%) of participants were between the age of 54 to 70 years with a median age 64 years. Majority, 66 (75%), were unemployed and 46.6% had no formal education. Participants with multibacillary type of leprosy were 72.7% and forty three (48.9%) resided at the leprosarium Center. Ocular findings were present in 69% of study participants. Cataract was the most common (45.5%), 15.6% had lagophthalmos, 9.1% had keratitis and 9% uveitis. There were 19 (21.6%) patients who were blind with the best corrected visual acuity of less than 3/60 in the better eye. Conclusion: Patients with leprosy and ex-leprosy have significant prevalence of ocular pathologies which affects their vision. Patients with low socio-economic status and Multibacillary type of leprosy are more affected. Cataract is the most common cause of visual impairment, however other sight threatening conditions like lagophthalmos, exposure keratitis and uveitis are also common.