Monolateral Epithelial Hyperplasia Caused by Boiling Oil Misdiagnosed as Unilateral Keratoconus

PURPOSE: To describe a case of monolateral decreased visual acuity due to corneal epithelial hyperplasia that occurred after a thermal burn. A surgical approach can restore visual acuity and the corneal surface regularity. METHODS: The patient was concerned about a decrease in visual acuity. The slit-lamp examination and general medical history were not significant. The diagnosis was achieved by performing an anterior segment tomography, which showed an increased epithelial thickness with a reduced stromal thickness. No pathological anterior or posterior elevation areas were detected. Corneal biomechanics evaluation confirmed the absence of keratoconus. After further interrogation, the patient recalled she had a domestic mild thermal burn with boiling oil. RESULTS: The patient underwent a corneal epithelial debridement and achieved an uncorrected distance visual acuity of 20/20. CONCLUSIONS: The authors highlight the importance of performing anterior segment tomography and of studying the epithelial thickness after corneal burns, even in clear corneas. [ Journal of Refractive Surgery Case Reports. 2022;2(3):e55–e59.]