The second Round Table Discussion (RTD) of the Philippine Society of Ophthalmic Plastic and Reconstructive Surgery was held via Zoom on June 30, 2021. One case was presented by a resident with their respective adviser(s) from each of the three invited institutions. The first case “A Massive Surprise”, presented by Dr. Earl Pactores Sarabosing and advised by Dr. Luisa Maria Ko and Dr. Jonathan Del Prado from Vicente Sotto Memorial Medical Center, was on Granulomatosis with Polyangiitis in the orbit with associated sinusitis. The second case “Elderly Female with Loss of Vision in the Left Eye”, presented by Dr. Cyrus Ayahao and advised by Dr. Roland Joseph Tan from Baguio General Hospital, was on a monocular patient with diagnosed orbital melanoma after excision biopsy on the side with the residual eye. The last case “Double Trouble”, presented by Dr. Janin BIllano and advised by Dr. Gabriel Bunagan from Southern Philippines Medical Center, was on a patient who developed strabismus after an episode of orbital myositis secondary to orbital cellulitis. Following the new format, the cases were each followed by a comprehensive discussion courtesy of Dr. Sharah Mae Kaw-De Castro, Dr. Andrei Martin, and Dr. Margarita Bondoc-Hermosa. Also active in giving their input were our esteemed PSOPRS members Dr. Reynaldo Javate and Dr. Alex Sua, as well as our PSOPRS honorary member Dr. Javed Ali.