The emergency clinician is frequently in the position of receiving, evaluating, and initiating treatment on horses with ophthalmic emergencies or orbital trauma. In the best of circumstances, an ophthalmologist is available to guide initial therapy and ultimately assume responsibility for the management of the patient during the remainder of its hospitalization, but this is not always the case. The information presented here is meant to provide the emergency clinician with basic guidelines for the initial assessment and management of horses sustaining ocular injuries or presented with an ophthalmic emergency. The article provides initial information regarding prognosis, descriptions of indicated diagnostics and procedures that may need to be performed on an emergency basis, and suggestions regarding early therapy. Whenever possible, the management of such cases should be overseen or assumed by a veterinary ophthalmologist after the emergent stabilization of the patient.