At surgery, placement of the eyelid speculum alone provoked ectasia of the temporal sclera with impending rupture. An 18 × 10-mm full-thickness donor scleral patch graft was placed over the thinned area and sutured to healthy sclera along its edges (Figure 2). Immediately, a 3-port pars plana vitrectomy was performed. Following vitreous removal, extensive preretinal and subretinal fibrous proliferation surrounding an inferotemporal peripheral retinal break was identified. The retina was reattached by membrane peeling, relaxing retinotomy for 3 clock hours, and perfluorocarbon liquid (Perfluoron, Infinitech, Chesterfield, Mo). Endolaser retinopexy was performed, the perfluorocarbon liquid exchanged for air, and the air exchanged for 16% perfluoropropane gas. It was not possible to completely cover the scleral graft by mobilizing conjunctiva; 1 week later, a free conjunctival autograft from the contralateral eye was placed over the exposed sclera.