A 77-year-old man was referred to the cornea service for painless, progressive blurring of vision in his left eye. His best-corrected visual acuity was 20/40 OS, and the patient reported that his vision had waxed and waned over several months. His ocular history included cataract surgery in the left eye, followed by yttrium-aluminum-garnet capsulotomy 2 months before his referral. Of note, he had recently undergone Mohs surgery and subsequent reconstruction for squamous cell carcinoma in situ of the lateral canthus in the fellow eye; he also had a medical history of multiple skin malignant neoplasms.
Slitlamp examination findings were notable for a grayish cornea opacity that appeared to be lusterless, abutting the nasal limbus and extending into the visual axis (Figure 1A). There was no apparent conjunctival erythema or appreciable feeder vessels at the limbus. The rest of the examination findings, including the fundus, were unremarkable. Anterior segment optical coherence tomography (AS-OCT) indicated that the hyperreflective corneal lesion did not involve the cornea stroma (Figure 1B).