A systematic approach to the history and examination of the ocular emergency patient allows for a correct diagnosis. Each clinical symptom and sign provides important clues to the underlying condition. Is there a history of trauma or did the condition appear spontaneously? Is this a recurrent problem? Is there a history of decreased vision, redness, pain, photophobia, tearing, itching, burning, diplopia, or floaters? The ocular history is important for establishing a provisional diagnosis. With a careful examination all the clinical signs can be detected. Is the vision affected? Are the pupils equal and refractive? Is there an afferent papillary defect? Is there a full range of extraocular muscle movements? Is there evidence of a field defect on confrontation testing? Are there any abnormalities of the lids, conjunctiva, lacrimal puncta or sac, cornea, anterior chamber, iris, or lens? Are there any abnormalities of the vitreous, optic disc, retinal arteries or veins, macula, or peripheral retina? Is the intraocular pressure high? This chapter describes the important steps in the evaluation of the ocular emergency patient.