Bacillus cereus panophthalmitis secondary to intravenous drug use typically leads to an explosive ocular and/or orbital infection. Though several cases of B. cereus panophthalmitis secondary to intravenous drug use have been reported, no clear consensus exists regarding preferred surgical technique and orbital reconstruction. Additionally, no cases describe delayed dermis fat graft placement following enucleation for such cases. Herein, a case of B. cereus panophthalmitis secondary to intravenous methamphetamine use is presented, where delayed dermis fat graft placement following enucleation and orbital washout provided an excellent functional and cosmetic outcome.