Purpose: To evaluate the international eye injury scene and design a standardized terminology for mechanical eye injuries. Methods: Surveys of practicing ophthalmologists and an extensive review of the international ocular trauma literature. Development of the Birmingham Trauma Terminology (BETT) using a logic-based approach. Results: BETT always uses the entire globe as the tissue of reference. Its well-defined terms encompass all types of mechanical eye injury. A one-to-one relationship exists between terms and clinical conditions. Conclusion: BETT provides an unambiguous, consistent, simple, and comprehensive system to describe any type of mechanical globe trauma. Endorsed by several societies and peer-reviewed journals as the standardized international language of ocular traumatology, BETT is expected to become the preferred terminology for categorizing eye injuries in daily clinical practice.