Retinopathy of prematurity (ROP) was observed in 28 of 185 pre-term infants born in 1982-84 and under regular ophthalmic surveillance after delivery; their gestational age (GA) range was 25-35 weeks; four became blind. All 28 attended ophthalmic reassessment at age 7-10 years and were compared with 60 pre-term subjects of the same cohort who had not developed ROP. Considering psychomotor development, 45 (51%) of the total 88 had evidence of central nervous system (CNS) damage; minor in 24 and major in 21 (cerebral palsy in particular). With correction for drop-outs, the regional frequency of severe CNS damage was 24% for birth weight below 1500 g and 29.6% for GA less than 32 weeks. Except for the selection due to initial inclusion for ROP surveillance, we have no explanation for the high frequency at the present follow-up. Statistically, the ocular damage of ROP appeared unassociated with CNS impairment. An analysis of perinatal factors based on matched pairs did not indicate any definite association with subsequent development of ROP and/ or CNS damage.