Reference : Hisn al-Muslim 82

اللّهُـمَّ عافِـني في بَدَنـي،
اللّهُـمَّ عافِـني في سَمْـعي،
اللّهُـمَّ عافِـني في بَصَـري،
لا إلهَ إلاّ اللّه أَنْـتَ.
اللّهُـمَّ إِنّـي أَعـوذُبِكَ مِنَ الْكُـفر، وَالفَـقْر،
وَأَعـوذُ بِكَ مِنْ عَذابِ القَـبْر، 
لا إلهَ إلاّ أَنْـتَ.
(ثلاث مرات)
Allāhumma `āfinī fī badanī, 
Allāhumma `āfinī fī sam`ī, 
Allāhumma `āfinī fī baṣarī, 
lā ilāha illā ant. 
Allāhumma innī a`ūdhu bika mina ‘l-kufri, wa ‘l-faqr, 
wa a`ūdhu bika min `adhābi ‘l-qabr, 
lā ilāha illā ant.


O Allah, make me healthy in my body.
O Allah, preserve for me my hearing.
O Allah, preserve for me my sight.
There is none worthy of worship but You. 
O Allah, I seek refuge in You from disbelief and poverty,
and I seek refuge in You from the punishment of the grave. 
There is none worthy of worship but You
(Recite three times in Arabic.)

Reference:
Abu Dawud 4/324, Ahmad 5/42, An-Nasa'i, 'Amalul-Yawm wal-Laylah (no. 22), 
Ibn As-Sunni (no. 69), Al-Bukhari Al-'Adab Al-Mufrad. Its chain of 
transmission is good (Hasan), Ibn Baz, p. 26.

Chapter: In the morning and evening