Objectives:To describe the epidemiology of paediatric ocular trauma (POT) presenting at a tertiary health institution in Ghana and factors influencing visual outcome. Design:Prospective study. Setting:Korle-Bu Teaching Hospital, Accra, Ghana. Participants:Children aged 0-15 years presenting with trauma involving the globe and/or adnexa from January 2022 to February 2023. Interventions:Clinical management of ocular trauma. Main outcome measures:best-corrected visual acuity at 6 weeks, and factors influencing visual outcome. Results:A significant proportion of children (59.2%) presenting with trauma were between ages 6-10 years (mean age 7.2±3.3 years), with the majority being male (70%). There was no caregiver at the time of injury in most cases (76%). Globe injuries were predominant (78.6%), and most (56.3%) were open globe injuries (OGIs). OGIs and organic objects as causes of injury were associated with unfavourable visual outcomes (p < 0.05). Early presentation, an inorganic object as the cause of injury, a favourable presenting visual acuity, a closed-globe injury, and a higher Paediatric Ocular Trauma Score (POTS) were associated with a favourable visual outcome. A third of children were blind (best-corrected visual acuity < 3/60) in the affected eye at follow-up. Conclusion:Open globe injuries were the most common type of injury and often resulted in poor visual outcomes. Better public awareness, caregiver education, and adult supervision can help prevent these injuries. Funding:None declared.