Purpose. The aim of this study was to determine the proportion of ophthalmic self-medication and associated factors among adult ophthalmic patients attending Borumeda Hospital, Northeast Ethiopia, 2019. Methods. An institution-based cross-sectional study design was conducted on 402 participants at Borumeda Hospital from April 29 to May 24, 2019. Systematic random sampling technique was used to get study participants. Data were collected with a face-to-face interview by using a semistructured questionnaire. Data were entered into Epi Info 7 and analyzed by SPSS 20. Descriptive statistics and binary logistic regression analysis were employed. P values of less than 0.05 were considered statistically significant. Results. The proportion of ophthalmic self-medication was 28.6% (95% CI; 24.6–33.3). Age-group 29–42 years (AOR: 2.19, 95% CI: 1.06–4.52), absence of health insurance (AOR: 4.29; 2.35–7.84), more than 10 kilometer traveling distance to get eye services (AOR: 3.11; 1.58–6.12), previous experience of ocular illness (AOR: 2.62, 95% CI: 1.53–4.48), family or friend experience of ocular illness (AOR: 2.65, 95%CI: 1.43–4.92), availability of ophthalmic medicine bottle/tube at home (AOR: 4.59, 95% CI: 2.36–8.92), and poor knowledge about hazards of self-medication (AOR: 6.22; 3.26–11.85) were significantly associated with ophthalmic self-medication. Conclusion and Recommendations. The proportion of ophthalmic self-medication was high, which needs stakeholders’ attention. The policymakers and regulatory body better to scale-up health insurance coverage, nearby accessible eye care services, improve knowledge of patients regarding the effect of ophthalmic self-medication, and proper disposal of leftover eye medication from the house. It is better to take regulatory actions on those who dispense ophthalmic medications without prescription.