The aim of this study was to determine the ocular manifestations of chronic kidney disease among patients receiving hemodialysis at the University of Benin Teaching Hospital, Benin City, Nigeria. This was a descriptive, cross-sectional study of consecutive patients on hemodialysis. The study was conducted from November 2011 to January 2012. A structured questionnaire was administered and patients had three ocular examinations done at baseline and at monthly intervals. Data analysis was by SPSS version 16. A p-value <0.05 was considered as statistically significant. A total of 96 patients, comprising 63 (65.6%) males and 33 (34.4%) females participated in this study. Their ages ranged between 19 and 75 with a mean of 44.2 ± 13.36 years. Chronic glomerulonephritis was the major cause (36.5%) of chronic kidney disease. The prevalence of visual impairment was 28.1% and 5.2% were blind. The most common ocular finding in the anterior segment was pallor (84.4%), followed by red eye (19.8%) and corneo conjunctival calcification (16.7%). The relationship between corneo-conjunctival calcification and duration on hemodialysis was statistically significant (p=0.039). In the posterior segment hypertensive retinopathy was present in over a third (43.8%), followed by macular oedema (20.8%) and diabetic retinopathy (11.5%). The major causes of visual impairment were diabetic retinopathy (34.4%) hypertensive retinopathy (25%) and maculopathy (25%). The proportion of patients with dry eye was 39.6%. The relationship between dry eye and duration on hemodialysis, aetiology of CKD and ocular calcification was not statistically significant (p=0.453, 0.163 and 0.669 respectively). IOP reduced significantly after hemodialysis at baseline, after the first and second months (p < 0.05). The relationship between duration on hemodialysis and IOP was not statistically significant in both eyes (p=0.115 and 0.937 respectively). Ocular manifestations of CKD and hemodialysis can lead to visual impairment. There could also be changes in the IOP of these patients. Management should be multidisciplinary, involving the ophthalmologist and nephrologist. Regular ocular examinations are indispensable in the prevention of blindness in this unique group of people who have already lost the function of one organ.