This study aimed to evaluate whether best corrected visual acuity changed significantly in the second decade of life in those with albinism and the impact of extraocular muscle surgery and type of albinism on change in acuity during the second decade. The study included 41 patients with mean age of 10.99 years at visit a, and 19.11 years at visit b. Best acuity was a mean of 20/65 (range 20/25-20/160) at visit a and mean 20/51 (range 20/20-20/125) at visit b. Ninety-eight percent showed some improvement. Seventy-eight percent showed at least one line of acuity improvement. Surgery for abnormal head posture, nystagmus and / or strabismus was undertaken in 14 patients. Nine had improved acuity and five had stable acuity. The authors propose changes in nystagmus, developmental maturation, use of a precise null point likely account for improved acuity with increasing age. It is possible that extraocular muscle surgery was also a contributing factor. Oculocutaneous albinism types 1B and 2 had the best visual outcomes.