Introduction: Tuberculosis continues to be a major health problem in India. Ocular tuberculosis can involve any part of the eye. It can occur with or without active systemic tuberculosis. Among the antitubercular drugs, ethambutol is most commonly associated with ocular toxicity. Aim: This study was done to find the incidence of ocular tuberculosis among patients with active systemic tuberculosis and to study the ocular toxicity of antitubercular drugs. Methods and Materials: 152 patients of newly diagnosed active systemic tuberculosis (pulmonary and extra-pulmonary) were screened for ocular tuberculosis. A detailed general and ocular examination including visual acuity, slit lamp bio-microscopy, indirect ophthalmoscopy, color vision was done. Specialized investigations including Fundus fluoresce in angiography, Visual fields and VEP were done where indicated. Montoux test, ESR, AFB, Quantiferon TB gold test were done. They were followed up at 2mths and 6mths to look for any ocular toxicity of antitubercular drugs. Results:  9 cases (5.9%) were detected to have ocular tuberculosis, of these 5 cases had pulmonary and four cases extra-pulmonary tuberculosis. Of the 52 cases on treatment with ethambutol 2 cases (3.8%) were detected to have ethambutol toxicity. They had constriction of visual fields which recovered 2 months after discontinuing the drug. Conclusion: The incidence of ocular tuberculosis in a study of 152 cases of active systemic tuberculosis was 3.28 % and the incidence of ocular toxicity was 3.8 % among patients receiving ethambutol. The ocular toxicity was reversible on discontinuing the drug.