BACKGROUND Severe eye burns usually result in extensive necrosis of the conjunctiva and subconjunctival tissue. To reduce the reactive inflammatory response excision of the necrotic tissue is necessary. METHODS Between August 1990 and December 1994 fluorescein angiograms of the anterior eye segment were performed in 13 (17 eyes) patients with most severe eye burns. The angiographies were carried out 1-4 days after the accident. Conventional photo angiography was performed using a fundus camera (NF 505-AF Nikon). RESULTS The angiograms revealed characteristic patterns that provided exact information on the perfusion of burned conjunctival and underlying tissue. It was particularly useful in the detection of clinically not recognisable subconjunctival ischemia. In addition, perfusion of the episcleral vessels and the extent of scleral ischemia could be quantified. According to the angiographic findings subtile excision of the necrotic tissue was performed and vascularized tissue was preserved. CONCLUSIONS Anterior segment angiography is a valuable method in assessing the extent of necrosis of the conjunctiva and underlying tissue and in determining scleral ischemia. It provides a basis for deciding the extent of surgical debridement of necrotic tissue in the acute phase of the burn. The quantification of limbal and scleral ischemia may give useful information for early plastic-reconstructive procedures.