Corneal changes associated with hypertrophic scars of the eyelids

Acquired astigmatism secondary to scar contracture of the eyelids was diagnosed in a burned patient, with decrease in visual acuity to 20/400. This was associated with a persistent mosaic pattern of the cornea when stained with fluorescein. Visual acuity returned to normal and the mosaic pattern disappeared after treatment of the scars. This unusual problem should be looked for in patients with scarred eyelids to decrease morbidity and prevent possible permanent corneal changes.