Phthisis bulbi represents an end stage ocular disease characterized by small, shrunken, disorganized and non functional eye leading to esthetic facial disfigurement. Cicatricial ectropion of lower lid requires complex procedures poses challenge to most ophthalmologists. A 24 year female presented with left lower eyelid ectropion and unaesthetic and shrunken left eye. She sustained left sided facial injury following road traffic accident 7 months back. Primary repair was done at peripheral centre. She had lower lid cicatricial ectopion, upper lid cicatricial retraction and phthisis bulbi along with old depressed fracture of frontal bone. Multiple Z plasty of lower lid cicatrix was done along with evisceration and PMMA ball implant. Following surgery six injections of 5-Fluorouracil in combination with triamcinolone acetonide were given at 2 weeks interval initially and then after 2 months. A custom made ocular prosthesis was fitted. Socket achieved satisfactory cosmetic outcomes.
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