Aim: The aim of the study is to identify ophthalmic manifestations in children with delayed milestones. Materials and Methods: This was a prospective, observational, and interventional study carried out at tertiary care hospital during July 2016–June 2018 where preschool children with a history of delayed milestones were included. Results: A total of 50 preschool children were included. Male patients (33 [66%]) showed higher incidence than females (17 [34%]). Age group 0–1 year had maximum 17 (34%) cases, followed by 13 (26%) in 1.1–2 years, 6 (12%) in 2.1–3 years, and 7 (14%) each in 3.1–4 years and in 4.1–5 years. Most common ocular manifestations found were congenital cataract 10 (20%), followed by refractive error 8 (16%), 5 (10%) each for optic atrophy and retinal detachment, 4 (8%) strabismus, 3 (6%) nystagmus, 2 (4%) glaucoma, and 1 (2%) each for proptosis, disc hypoplasia, microcornea, Persistent Hyperplastic Primary Vitreous (PHPV), iridocorneal endothelial syndrome, and cone dystrophy. Twenty (40%) patients needed no intervention, while glasses were given to 14 (28%) patients, 10 (20%) underwent cataract surgery and 3 (6%) retinal detachment surgery, 2 (4%) patients started on topical medication, and 1 (2%) underwent trabeculectomy surgery. Refractive error found in 8 (16%) children. Twenty-one (42%) patients were associated with various systemic diseases. Along with their primary ocular diseases, five (10%) patients had association with other ocular findings. Conclusion: Children showed improvement in their behavior posttreatment. Parents noticed attentiveness and environmental awareness of children in the surroundings. Children became more responsive in parent–child playful games using colorful objects.