This study sought to determine the state of management of binocular vision anomalies by eye care facilities in two major cities in Ghana: Accra and Kumasi. Using the snow balling technique, 86 eye care centres were sampled from the two cities from January to February, 2014. Well-structured questionnaires, verbal interviews and in most cases observational check-ups were employed in the data collection process. Out of the 86 clinics, 51 (59.3%) were located in the Accra metropolis. Binocular Vision Anomalies were reported to be managed by 63 (73.3%) clinics. Majority of the clinics (69.8%) managed accommodative dysfunction with added lenses (69.8%) being the most-employed method. Overall, 79 (91.9%) clinics reported that they referred unmanaged cases and mostly to the ophthalmologist (55.7%). It was found that reports of adequate training in management of binocular vision anomalies and number of instruments owned by the clinics were positively associated with management of binocular vision anomalies (p value =0.001 and p value =0.000 respectively). Based on the report of the clinics, it could be concluded that although some form of binocular vision anomalies are managed by most clinics, there is possibly lack of efficient provision of services as most clinics lacked instruments that are required in detecting, measuring and managing Binocular vision anomalies. It is therefore recommended that to ensure provision of more efficient and quality binocular vision services to clients, eye clinics in the country should endeavour to obtain the equipment that are necessary for managing Binocular vision anomalies.