Epidermal growth factor receptor inhibitors may make sense for ocular surface and orbital SCCs since EGFR inhibitors have shown efficacy in treatment of head and neck SCC and skin SCC.1- 5 Our group has previously shown expression of EGFR in ocular squamous carcinomas.6 It is important for patients and their family members to understand the investigational and off-label nature of oral EGFR inhibitors for treatment of orbital SCC. While we have observed evidence of activity for EGFR inhibition in these 2 patients, overall response rates and expected response duration in this setting are not known. Further study of this approach is indicated. There also is the potential for treatment-related toxic reactions, hypersensitivity, folliculitis, diarrhea, and fatigue. Admittedly, the follow-up time for our patients is relatively short. Nonetheless, these patients experienced a significant improvement in their quality of life, indicating that oral erlotinib or intravenous cetuximab is a reasonable option for palliative treatment of orbital and ocular surface SCC.