After a mass grew on his right eyeball for six months, a 74-year-old man was diagnosed with a corneal keloid, according to a new report in the journal JAMA Ophthalmology. The man had previously had cataract surgery, and he ended up in an ocular oncology clinic after the mass grew to 10 by 10 millimeters. In the report, the mass was described as "a pearly white, raised, gelatinous, corneal lesion."
Corneal keloids are very rare. A 2008 report estimated that there had been fewer than 80 cases since 1865. According to the new case report, corneal keloids are more likely to affect people 30 and under.
An isolated corneal keloid on one eye, like the one in the new case report, is usually a result of eye trauma, infection, or surgery. A corneal keloid can also occur after a bout of keratouveitis, a condition that causes the eye to swell.
But it's also possible to be born with a corneal keloid. Corneal keloids in both eyes are usually associated with genetic disorders, including Rubinstein-Taybi syndrome and Lowe syndrome.
Corneal keloids are characterized by "a haphazard arrangement of fibroblasts, collagen bundles, and blood vessels," according to a report on the condition. When someone has a corneal keloid, their cornea can be clear or opaque.
A corneal keloid can be confused for a hypertrophic, or raised, scar. However, corneal keloids can appear years after trauma to the eye and can get larger as time goes on, and the same can't be said for hypertrophic scars. The new case report explains that the patient "noted a corneal scar after the cataract surgery that gradually thickened over the ensuing six months."
According to the case report, a blade was used to "gently but completely excise the lesion. Pathology results were positive for corneal keloid." Doctors usually diagnose a corneal keloid by examining it microscopically, although corneal keloids are sometimes diagnosed just by looking at them.
Treatment for a corneal keloid depends on how severe it is. "Treatment for corneal keloids (excision) is generally reserved for those causing significant visual dysfunction," according to the case report. The patient had "severely limited vision," but he could make out movements in front of his right eye. "He is subjectively doing well but will be followed up for the development of recurrence," the report says of his current condition.