Corneal keloid caused by persistent atopic eye disease and chronic eyelid closure

PURPOSE: This report aimed to present a case of corneal fibrosis with prolonged atopic blepharitis caused by psychological resistance to steroid treatment. OBSERVATIONS: A 49-year-old woman presented with atopic dermatitis and a history of panic attack and autism spectrum disorder. The upper and lower eyelid margins of her right eye became adherent, and the eyelid remained closed for several years due to refusal of steroid treatment and aggravation of blepharitis. During the initial examination, a lesion with elevated white opacity on the corneal surface was observed. Subsequently, superficial keratectomy was performed. The histopathological findings were indicative of corneal keloid. CONCLUSIONS AND IMPORTANCE: Persistent atopic ocular surface inflammation and prolonged eyelid closure resulted in the formation of a corneal keloid.