Purpose: To determine the frequency of ocular findings, the risk factors, and the relationship between leukemic related systemic manifestations and the development of ocular lesions amongst adults (over 16 years) with leukemia attending hematology clinics in two tertiary hospitals in Lagos, Nigeria. Materials and Methods: A clinic based case control muilticenter study that was conducted at both the Hematology clinics and the Eye clinics in Lagos University Teaching Hospital (LUTH)and Lagos State University Teaching Hospital (LASUTH) from May 2012 to December 2012.The cases were newly diagnosed leukemic patients from the hematology clinics interviewed after confirmation by Bone Marrow Aspirate, and then examined with their ocular findings recorded. The control group were people from the eye clinics who escorted patients to the eye clinics for ocular emergencies whom themselves had no complaint. These were age and sex matched with the cases, they had full blood count, blood film and other tests done to exclude systemic co-morbidities of hypertension, diabetes, sickle cell disease and human immunodeficiency virus/Acquired immune deficiency syndrome. All the study population had detailed ocular examination done including visual acuity test, slit lamp examination, dilated fundoscopy and binocular indirect ophthalmoscopy. Those who read 6/9 or less with a line or more improvement with pinhole were taken as ametropic, and refracted. Clinical data from each individual in the study was statistically collated and analyzed with SPSS 17. Means were compared using the student t test, chi square , odds ratio and logistic regression were done to measure the strength of association using a p<0.05 as statistically significant.