This study was performed to determine patient's perceptions towards eye health care systems in a tertiary eye care center in Nepal. Subjects were randomly selected from the outpatient department of Tilganga Eye Centre (TEC), a tertiary eye care center in Kathmandu, Nepal. The study was performed in April 2003 with 54 patients responding to several questions concerning their satisfaction of the eye care process. Over 40 (74.1%) of the respondents expressed overall satisfaction with the service provided by the hospital staff, and 4 (7.4%) were not satisfied. In addition, a total of 40 (74.1%) respondents were dissatisfied with the extended waiting time for eye examinations and other ocular services, while 7 (13.0%) were satisfied. The study shows that the majority of patients who are treated at Tilganga Eye Centre have positive feelings about Tilganga and its service system. Some processes, however, could be altered or improved to augment the overall quality of patient care.