Children with significant learning disability have a much higher incidence of visual problems, including significant refractive error, strabismus, cerebral visual impairment, disc anomalies and visual field defects. The article provides a discourse of the prevalence and causes of learning disability and an outline of the more common ocular and non-ocular associations. Suggestions for how optometrists can successfully meet the eye care needs of this vulnerable group in the community and special schools setting is discussed.