This patient’s case is unique: it is very rare to see conjunctival squamous cell carcinoma in both eyes at the same time, moreover it is rare to see them in advanced stage. This is a sad state of HIV patient with bilateral conjunctival squamous cell carcinoma. Left eye is in more advanced stage, and the cancer spreads in intraepithelial and papillomatous fasion to both upper, lower bulbar conjunctiva, upper tarsal conjunctiva and penetrates into cornea. Total orbital exenteration (involving the eyelids) is indicated for this eye. Right eye has a big protruding squamous cell carcinoma involving the limbus and third part of cornea infero-temporally. No obvious intraepithelial spread is seen upon examination of lower fornix and lateral/medial bulbar conjunctiva. Here, I opted to go for several stages of local chemoreduction (5-FU in 4 weekly cycles), and then will choose no-touch excision technique with cryo to the conjunctival margins +/- scleral bed. This eye is seeing comparatively well, and is amenable to the treatment at this stage, although with high chances for recurrence.