New York Eye and Ear Infirmary of Mount Sinai (NYEE) started its eye radiation therapy program in the early 1990s. Since that time, its ophthalmologists have offered eye- and vision-sparing treatments with great success for more and more complex cases. In two such cases, patients who each had squamous cell carcinoma that grew from the conjunctiva into the eye illustrate the breadth of skills, training, and decision-making required for these delicate procedures.