Corneal ocular surface squamous neoplasia usually begins at the limbus and presents as an avascular translucent sheet over the corneal surface. This case report describes a 67-year-old man with an unusual isolated, keratinous nodular corneal lesion. Slit-lamp examination showed an elevated, avascular, whitish plaque-like lesion at the central cornea surrounded by a normal corneal epithelium, with reduced visual acuity of 20/200 in the right eye. Anterior segment optical coherence tomography displayed a hyper-reflective, thickened epithelium with back shadowing. Histopathology showed keratinising hyperplastic stratified squamous epithelium with parakeratosis and moderate nuclear pleomorphism in lower second/third of epithelium suggestive of moderate dysplasia. His visual acuity returned to 20/20 after surgical excision but he developed multifocal corneal recurrences 6 weeks later, which were successfully managed with seven cycles of topical interferon immunotherapy. There are no recurrences observed at 6 months of follow-up.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8276288PMC
http://dx.doi.org/10.1136/bcr-2021-243925DOI Listing

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