This video is tough to watch for an anterior segment surgeon. There are rare cases where we need to perform an evisceration like this case of a blind, painful, hypertensive eye. Evisceration is a surgical procedure involving removal of the intraocular contents while preserving the scleral shell, conjunctiva, and extraocular muscles. It is typically indicated for blind, painful eyes due to end-stage glaucoma, trauma, or infection. Under general or local anesthesia, a 360-degree peritomy is performed to expose the sclera. A corneal trephination or anterior scleral incision is made to access the globe. The intraocular contents, including uveal tissue, lens, and retina, are carefully removed using a curette or evisceration spatula. Hemostasis is achieved, and the scleral cavity is irrigated thoroughly. A sclerotomy may be performed to enlarge the opening and accommodate an orbital implant, which is placed within the scleral shell to restore orbital volume. The sclera is closed over the implant with interrupted or running sutures. The conjunctiva and Tenon’s capsule are re-approximated in layers. Postoperative care includes antibiotics, anti-inflammatory agents, and eventual prosthesis fitting after healing.