Retinopathy of prematurity (ROP) is an emerging cause of childhood blindness in low- and middle-income countries. We review the magnitude, causes, prevention and treatment of visual impairment caused by ROP over a time span. A review of literature on short and long term structural and functional outcomes of ROP was conducted through PubMed search primarily focusing on studies published during the last decade. Additionally, we have shared data from our institute located in Southern India. Visual Impairment in ROP-treated children ranged from 4.1% to 30% in various settings, attributable mainly to refractive errors, amblyopia, strabismus and perinatal neurological events followed by structural changes like macular scarring and retinal detachment. We conclude that towards an early detection and a proper management of all the above mentioned conditions, these children need to be followed-up for a long time by a committed pediatric ophthalmologist at a specifically scheduled interval. The overall success depends upon the strength of the networking system between parents/neonatologists/pediatricians/pediatric ophthalmologist and a retina specialist.