Six eyes of three patients with severe body burns had intraocular pressure ranging from 37.2 to 81.7 mm Hg. Because of extreme orbital congestion, lateral canthotomies were performed, which caused abrupt decrease in intraocular pressure (range, 17.6 to 49.0 mm Hg). None of the patients had a history of glaucoma, narrow angles, or any precondition for a pupillary block mechanism. Two patients survived and neither had optic nerve damage or increased intraocular pressure after hospital discharge. Tonometry should be performed in patients with severe burns and orbital congestion, especially in those patients receiving large amounts of intravenous fluids. Lateral canthotomies may be of benefit to relieve potentially damaging high intraocular pressure.