Cyclooxygenase isoenzymes (COX-1 and -2) catalyze the conversion of arachidonic acid to prostaglandins (PGs) and play a significant role in the health and disease of the eye. Experimental animal models of ocular diseases have been used to assess the effects of the selective COX inhibitors (COXIBs), and nonselective, nonsteroidal anti-inflammatory drugs (ns-NSAIDs) are currently employed in the management of various ophthalmic conditions. This paper provides a review of the comparative expression of COX-1 and COX-2 in the eye under normal and pathologic conditions, including the pathophysiologic role of PGs, and the effects of ns-NSAIDs and selective COX-2 inhibitors in the treatment of ophthalmic conditions.