Emergency services in the UK, including eye casualty units, are under stress because of increasing demand for services. Audit is an effective way to assess the delivery of services and improve them. This study reports on an audit carried out in the emergency eye care (EEC) service at the University Hospitals of Leicester NHS Trust and the impact of recommendations implemented from a previous audit. The main categories audited included source and mode of referrals, diagnosis, appropriateness of the referral, evidence-based management and attending professionals.