Trauma is one of the leading causes of monocular blindness worldwide. Recognizing, evaluating, and managing vision-threatening injuries, such as globe rupture, retrobulbar hemorrhage, intraocular foreign bodies, and hyphemas, are paramount for emergency physicians to reduce the risk of vision loss and other complications. Other emergent ocular complaints, such as acute-angle closure glaucoma, and retinal detachment also require temporizing emergency management that can reduce complications while awaiting definitive specialty care. Understanding these conditions and evidence-based management will enable the emergency physician to provide the most up-to-date standard of care.