Each year an estimated 1.3 million Americans suffer eye injuries. There is little information in the literature regarding the prevalence, demographic characteristics, and prognosis of these patients. The Eye Injury Registry of Alabama (EIRA) serves as the first and only statewide system of its kind for the collection of information on serious eye injuries. We have analyzed 736 cases of serious eye injury (injury involving permanent structural or functional change) accumulated by the EIRA between August 1982 and May 1986. Prognosis was found to be related to early diagnosis and initial vision. Individuals with follow-up vision of 20/40 or better were found in all early diagnostic groups, and 13% of patients with no light perception on initial examination had some improvement on follow-up. The worst visual prognosis was among those patients suffering blunt eyeball rupture, of whom 40% had no light perception and 25% regained vision of 20/100 or better.