Atrophic eyes are those with dimensions smaller than the average limits of normal eyes. Pathologically, this condition includes atrophy without shrinkage, atrophia bulbi and phthisis bulbi. Treatment varies between non surgical options including cosmetic contact lens, ocular prosthesis, cosmetic shell, facial prosthesis and surgical treatment including enucleation and evisceration. Management of atrophic eyes in children represents special challenge because the eye in a natural inducer of facial expansion, several options are available for treatment of such conditions.