Enucleation and the consequent facial changes result in both physical and emotional handicaps to affected patients. Management of anophthalmic sockets requires in-depth understanding of orbital anatomy, post-radiation changes and the available surgical options. In this chapter, we discuss anophthalmic socket management. Orbital growth retardation can occur following enucleation and is more severe following radiation for retinoblastoma. The insertion of an orbital implant encourages orbital growth in young children. Management of the contracted socket often requires multiple, staged surgeries to expand the orbital volume by bony and soft tissue reconstruction. Repair of conjunctival fornix contraction is essential for adequate retention of an ocular prosthesis. Eyelid and facial deformities associated with anophthalmos and radiation can be surgically corrected with good cosmetic results.