Common complications of this chemotherapy program include myelosuppression, nausea, vomiting, fever, sepsis, hair loss, and potential for cardiac damage, renal dysfunction, ototoxicity, and thrombotic or vascular compromise related to the intra-arterial approach. Reported ocular complications due to the regional administration include retinal vascular occlusion, exudative retinal detachment, ophthalmoplegia,38 optic neuropathy,39,40 and maculopathy.41 In the case of adenocystic carcinoma of the lacrimal gland, in which exenteration is planned, ocular complications to the ipsilateral eye are not a major consideration. Our patients tolerated the administration of chemotherapy well and experienced manageable side effects including hair loss, nausea, and fever. There were no ophthalmic complications to the fellow eye. It must be emphasized that the treatment regimen described is quite toxic, predicted to produce significant, but manageable cytopenia. The risks of neutropenic fever and sepsis and potential complications from intracarotid catheter placement and chemotherapy infusion including a neurologic catastrophe do exist. This treatment protocol should not be used without adequate support services available.