Equine eyes are predisposed to trauma due to their large globe size, prominent position, and normal equine behavior. Trauma to the cornea can lead to ulcerative keratitis and if not treated appropriately keratomalacia can ensue eventually leading to perforation of the globe and blindness. Thus, keratomalacia is a serious ocular problem in equines with severe consequences. The pathogenesis of this destructive disease, common infectious causes, how to manage it medically, and typical outcomes will be discussed.