Eyelid scars usually aren’t thick, but they’re important because they inhibit the movement of small, delicate structures. For concerns, both cosmetic and functional, post-traumatic scarring of eyelids and periorbital area can pose a challenge for ophthalmologists. But the antimetabolite 5-fluorouracil (5-FU) offers a versatile option for approaching this common problem. 5-FU injections given at the first sign of contracture can help minimize scar tissue and dramatically improve eyelid function. Given its proven and long-standing track record in oncology, off-label applications of 5-FU have expanded in recent years into orbital and adnexal efforts to modify keloids and hypertrophic scars.