To determine the pattern, the post-intervention visual outcome and the factors that determines the post-intervention visual outcome of ocular and adnexal injuries at the Guinness Eye Centre, Onitsha, Nigeria Materials and methods This was a prospective study. A sample size of 71 participants was calculated with 10% attrition and the number was then made up to 80. The Ethics Committee of the Nnamdi Azikiwe University Teaching Hospital, Nnewi approved the study. Consecutive new patients presenting at the Guinness Eye Centre, Onitsha with ocular and adnexal injuries were recruited. Data was collected over a period 6 months with each participant followed up for 3 months. Using a pre-tested study protocol, information was obtained on socio-demographics, injury history, physical examination, diagnosis, investigations, interventions and outcomes at presentation and during follow up. The time points during the follow up visits were 1 week, 1 month, 2 months and 3 months post-injury. The data analysis was done using the Statistical Package for Social Sciences (SPSS) version 25.0 with alpha level at 0.05. Results Eighty (1.1%) out of the 7576 consecutive new patients seen during the study period had ocular and adnexal injuries. There were 26 (32.5%) males and 54 (67.5%) females with the age range 3 - 83 years; median 25 years. The duration of the injuries before presentation ranged from 1 day to 1 month post injury; mean of 4.8 + 6.86 days. The distance travelled by the participants to the hospital was 5 - 230 km; median 6km.There was a significant relationship between place of residence and time of presentation (p = 0.012). xvii Thirty-six (45.0%) participants had closed globe injuries and 23 (28.8%) open globe injuries. Twenty-one (26.2%) participants had adnexal injuries only. While 35 (43.8%) injuries were accidently self-inflicted, sharp objects, 27 (21.6%) constituted the commonest agent of injury; 34 (42.5%) injuries occurred at home while children’s play constituted 20 (25.0%) cases. Forty-two (52.5%) participants had inpatient care and 38 (47.5%) outpatient; 48 (60%) participants had surgery and 32 (40.0%) medical treatment. The presenting visual acuity was > 6/18 in 33 (41.3%); between 6/24 - 3/60 in 6 (7.5%) and <3/60 in 41 (51.2%) participants. The final visual acuity, at 3 months follow up, was > 6/18 in 36 (47.4%); between 6/24 - 3/60 in 11 (14.5%) and <3/60 in 29 (38.1%) participants. However, the acuity improvement was not statistically significant. (p = 0.28). The commonest ocular and adnexal lesions at presentation were conjuctival injection; 76 (95.0%) participants and lid edema including mechanical ptosis; 59 (73.8%). The common ocular complications at 3 months were corneal opacity; 26 (32.5%) participants, traumatic cataract; 12 (15.0%) and secondary glaucoma; 10 (12.5%). Corneal opacity (p <0.001), traumatic cataract (p < 0.001) and secondary glaucoma (p <0.005) were significantly associated with blindness.