Fifty consecutive, severe ocular trauma cases with posterior segment involvement underwent vitreoretinal surgery over a 14-month period at a county hospital. Forty-five (90%) of the patients were boys and men, and the mean age was 27 years. The injuries were the result of assaults in 37 cases (74%), industrial accidents in six (12%), accidents involving children at play in six (12%), and child abuse in one (2%). Twenty-five (50%) of the injuries were inflicted by firearms, by knives or sharp objects in ten (20%), by baseball bats in two (4%), by broken glass in two (4%), and unknown in 11 (22%). Twenty-six (52%) were penetrating injuries, of which eight were double perforations. There were ten (20%) intraorbital foreign bodies and three (6%) intraocular foreign bodies. Forty-three (86%) of the cases had initial visual acuities of 20/400 or worse. After a minimum of six months' follow-up, 48.8% improved two or more lines visually, and 69.4% were anatomic successes. Unlike other ocular-trauma studies, where industrial accidents and sports-related injuries were the most common causes of the trauma, assaults with firearms were the most common cause of ocular trauma at this county hospital. The visual and anatomic surgical results, however, were similar to those of other ocular-trauma studies.