The aim of this study was to evaluate the influence of early and later postnatal growth variables on optic disc morphology in children (n = 53) born at gestational age <32 wk. On fundus photographs taken at a median age of 5.4 y, the optic discs were evaluated using digital image analysis and compared with those of a control group (n = 203). The results were analyzed in relation to gestational age, birth weight (BW) SD score (SDS), IGF-1 weight at postmenstrual age 32 wk (SDS), and weight, length, and head circumference (SDS) at follow-up. The preterm children's optic disc and neuronal rim areas were smaller than in the control group. Low BW (SDS) and weight at wk 32 (SDS) were associated with larger area of the optic cup and reduced neuronal rim area. Preterm children with known brain lesions (n = 6) had significantly larger cups than preterm children without known brain lesions. The association found between both low BW and poor early growth and later reduced neuronal tissue of the optic nerve indicate that early weight gain is important for neural development in preterm children.