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Objective: To report the ocular abnormalities found in children born after in vitro fertilization. Methods: Forty-seven children (25 girls and 22 boys) born after an in vitro fertilization pregnancy (mean [+ or -] SD birth weight, 2335 [+ or -] 817 g; range, 924-4300 g) and referred for ophthalmic evaluation were included in the study. All underwent a thorough ocular examination. Obstetric history was gathered following a detailed questionnaire with the mothers. Results: Of 70 eyes among nonverbal children, visual acuity was 'normal for age' in 60 (86%), 'fair' in 4 (6%), and 'poor' in 6 (9%). Visual acuity in 24 eyes in verbal children ranged from 6/6 to no light perception, with 4 (17%) having poor vision. Cycloplegic refraction disclosed an emmetropia in 22 (27%), hypermetropia in 47 (57%), and myopia in 13 (16%) of the eyes. Anisometropia of more than 1.0 diopters was found in 8 children. Major ocular malformations were observed in 12 (26%) of the 47 children. These malformations included Coats disease, congenital cataract, congenital glaucoma, hypoplastic optic nerve head, idiopathic optic atrophy, coloboma with microphthalmos, and retinoblastoma. Conclusions: Ocular anomalies were frequently observed in this cohort of offspring born after in vitro fertilization. A diligent and prospective prenatal search for such malformations should unveil the real prevalence of ocular malformations in children born after in vitro fertilization. Arch Ophthalmol. 2001; 119:1525-1529