Factitious bilateral crystalline keratopathy

We report a case of bilateral factitious crystalline keratopathy in an 18-year-old man. Initial slit-lamp examination revealed corneal ulcers characterized by stromal infiltrates with intrastromal blue refractile crystals O.D. greater than O.S. Through careful history taking, the patient admitted to bilaterally injecting eyeshadow into the corneal stroma. The importance of maintaining a high index of suspicion in bilateral atypical corneal ulcers in patients without a history of trauma or contact lens exposure is essential. Discussion of the differential diagnoses and approach to therapy is included.