Corneal keloid presenting forty years after penetrating injury: Case report and literature review.

A 64-year-old Caucasian man had been diagnosed with presumed ocular surface squamous neoplasia in the left eye and started on topical interferon alpha 2b drops. When we saw him, he provided a history of penetrating corneal injury more than forty years before. Slit lamp examination revealed a large, elevated, opaque lesion involving the left cornea. High-definition anterior segment optical coherence tomography revealed a hyperreflective lesion involving the anterior stroma with a relatively normal overlying epithelium. Based on the clinical history, slit lamp, and anterior segment optical coherence tomography findings, a giant corneal keloid was suspected, and the interferon drops were discontinued. He subsequently underwent a penetrating keratoplasty, and histopathologic analysis was consistent with corneal keloid. Corneal keloids may be seen decades after the initial trauma, and anterior segment optical coherence tomography can be a useful tool in differentiating these tumor-like lesions from other neoplasia.