Multimodal Imaging and Histopathology Features of a Corneal Keloid

A 38-year-old man with prior penetrating corneal injury from a fishhook presented with left eye opacity, which developed 26 years after trauma. Examination showed a corneal keloid extending inferiorly from the corneal scar (Fig A). Ultrasound biomicroscopy (UBM) and anterior-segment (AS) OCT demonstrated a lesion over the cornea that was separated from the corneal epithelium by a distinct plane and occasional clefts. The cornea and the lesion were clearly visualized on UBM, while the cornea was obscured by posterior shadowing in AS OCT (Fig B-C). Histopathology showed a fibrocellular tissue with bland-looking cells in a matrix of collagen and extracellular material (Fig D) (Magnified version of Fig A-D is available online at www.aaojournal.org).