BACKGROUND Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (HIV/AIDS) is a major cause of premature death globally. It has been noted to be associated with significant ocular morbidity and visual loss. In the Highly Active Anti-Retroviral Therapy (HAART) era, conditions like immune recovery uveitis (IRU) have emerged and the functional capacity of the newly reconstituted Cluster of differentiation (CD4+) cells remains questionable. There is paucity of published data on the frequency and types of ocular manifestations of HIV/AIDS in Enugu State. AIM To determine the ocular manifestations of HIV/AIDS and the relationship with CD4+ count in Enugu state with a view to making recommendations for improved ocular health of HIV positive patients. METHODS The study was a hospital based observational study of HIV positive patients in Enugu. After obtaining ethical approval from the University of Nigeria Teaching Hospital (UNTH) Health Research Ethics Committee, interviewer administered questionnaires were used to collect data from randomly selected 331 consenting adult HIV positive patients at the 1 Antiretroviral Therapy (ART) clinic of UNTH Ituku-Ozalla, Enugu state. The selected patients were also examined. Obtained data were cleaned, coded, double entered into a computer and analysed using Statistical Package for Social Sciences (SPSS) version 21. The demographic data of the participants, frequency and pattern of ocular manifestations were presented in frequency and percentages. The mean CD4+ cell count was analysed using mean and standard deviation. The association between the CD4+ count and ocular manifestations was determined using logistic regression analysis; and the relationship between socio-demographic factors, clinical factors and ocular manifestations was analysed using Chi square. A P value of < 0.05 was used to define statistical significance at 95% confidence interval.