Albinism is a relatively rare, often misunderstood condition. The plight of those living with albinism in Tanzania is a far cry from that of individuals affected in the UK. The complex classification and array of phenotype manifestations provide clinicians with a challenging diagnosis. The characteristic ocular features and defects associated with albinism are hurdles the practitioner must overcome in order to provide ocular comfort, and to maximise visual development. There is a pressing need for further research in albinism to develop evidence-based guidelines and to support practitioners and parents. Since the first investigation by St Hilaire (1832) (Kinnear et al. 1985, Oetting et al. 2003), our knowledge about albinism has increased markedly, but this review highlights key areas lacking explanation and insight.