Family practitioners working in Southern Africa often encounter ocular pathology. Eye trauma, seemingly easy to diagnose, presents many pitfalls. The ophthalmic manifestations of sexually-transmitted diseases such as gonorrhoea, syphilis and HIV-AIDS are easily overlooked in the initial phases of the disease. The devastating ocular effects of the traditional medicine, “muti”, are poorly explained and understood. We present our 12 years experience in Swaziland, Mozambique and South Africa. In our opinion, knowledge of such pathology is of paramount importance for the family practitioner, who is in the front line of healthcare.