OBJECTIVE To describe a case of leukoplakia and underlying intraepithelial squamous cell neoplasia of the palpebral conjunctiva presenting in a patient wearing an ocular prosthesis. METHODS The clinical presentation, histopathological findings and surgical outcome are described in a 62-year-old man in whom leukoplakic lesions of the palpebral conjunctiva in a socket fitted with an ocular prosthesis were noted in addition to squamous cell carcinoma of the lower lid skin. RESULTS Histopathological examination revealed islands of squamous cell carcinoma in the skin lesion and squamous cell carcinomain- situ in the leukoplakic conjunctival specimen. Successful tumour excision and lid reconstruction were performed. CONCLUSION This report highlights the successful treatment of longstanding conjunctival squamous cell carcinoma-in-situ associated with an ocular prosthesis and a general tendency to pre-neoplastic lesions of the skin. Regular examination of the sockets of patients wearing long-standing ocular prostheses is recommended.