Vitreous beta-hydroxybutyrate (BHB) was retrospectively analyzed in 1,795 forensic cases using the Pointe Scientific method. Comparison of vitreous BHB with vitreous glucose in 1,781 of the cases showed moderately good correlation r = 0.731. Comparison with blood alcohol levels in 1,561 of the cases showed no correlation r = -0.053. Vitreous BHB was a marker of diabetic ketoacidosis when above 6.0 mM with a vitreous glucose over 200 mg/dL. It was an indicator (greater than 50 percent) for alcoholic ketoacidosis when above 6.0 mM with a vitreous glucose below 200 mg/dL. Recommendations for interpretation of vitreous BHB: less than 0.4 mM normal; 0.41-1.2 mM slightly elevated, rarely (less than 1 percent) of concern; 1.21-2.0 mM moderately elevated, less rarely (2.5 percent) of concern; 2.01-6.0 mM significantly elevated, frequently of concern (12-48 percent); greater than 6.0 mM usually (100 percent in this study) indicated life-threatening conditions. Vitreous BHB was helpful evaluating cases with ketogenic conditions, especially diabetes and alcoholism. Abstract published by arrangement with John Wiley & Sons.