The emergency service is vital for healthcare system in any hospital. We seldom find emergency service that specifically deals in ophthalmic sciences. This study was conducted to analyze the process flow and the workload of patients in the emergency service of a tertiary care ophthalmic center. Aims and objectives: • To study the workload and profile of patients visiting casualty of Dr Rajendra Prasad Centre for Ophthalmic Sciences (RPC), AIIMS, New Delhi. • To study the process flow and workload of patients visiting casualty of Dr Rajendra Prasad Centre for Ophthalmic Sciences, AIIMS, New Delhi. • To analyze the profile of patients visiting casualty of Dr Rajendra Prasad Centre for Ophthalmic Sciences, AIIMS, New Delhi. Materials and methods: A descriptive, cross-sectional, and observational study was carried out for a period of 95 days from December 26, 2017 to March 31, 2018. The medical emergency records were reviewed for a period of 30 days from January 15 to February 15, 2018. The study employed fieldwork case study approach analyzing the triage processes and work practices of clinicians and nonclinicians in delivery of the ophthalmic emergency care. The workflow in casualty was studied and the data were collected using both computerized and paper-based records and forms apart from nonparticipant observations and informal interviews of the staff. • Inclusion criteria: All the patients entering the casualty irrespective of the seriousness of condition or registration done either at the admission counter or ophthalmic outpatient department (OPD) or walk-in patients. • Exclusion criteria: Patients not documented in any form or duplicate records. • Data analysis: Done by the Statistical Package for Social Science (SPSS) software. Observations and results: A total of 1,700 patients had visited the ophthalmic from January 15, 2018 to February 15, 2018. Out of this, 54.21% were registered under casualty registration. Whereas rest (44.03%) were registered in OPD and 1.77% were unregistered and improperly documented cases. The most important finding was that 71.86% patients of the Red Triage category belonged to age group 0–15 years. It was found that 36.76% patients were Green Triage patients belonging to different age groups. It was also observed that 64.18% of the males had attended the ophthalmic casualty and 35.82% female patients belonging to different age groups. About 99.24% cases coming to ophthalmic emergency were non-medicolegal cases (non-MLCs). Conclusion: It was observed that nonemergency patients accounted for maximum workload in ophthalmic emergency. Certain issues during documentation increased the waiting time of the patient in the admission process. The double entry system used by the nurses, initial manual entry in procedure book and later in HIS, leads to prolonged waiting time of patients. Waiting time of casualty patients also prolonged in emergency due to incoming OPD patients and unregistered patients.