The ocular frostbite involving cornea caused by low-temperature environment.

BACKGROUND: Corneal frostbite is a rarely reported condition, with unique pathophysiological characteristics distinct from classical frostbite of the extremities due to the cornea's specific anatomy and physiology. CASE PRESENTATION: We present a case of corneal frostbite caused by natural environmental exposure. Following a 3-hour marathon on ice at temperatures ranging from - 16 °C to -23 °C, the patient developed blurred vision in the right eye and bilateral photophobia with eye irritation. Clinical examination revealed stromal and endothelial edema of cornea in the right eye, with bilateral punctate corneal epithelial defects and conjunctival congestion. After 4 weeks of topical treatment, the patient's visual acuity and epithelial integrity were fully restored, though a permanent filiform endothelial scar remained. CONCLUSIONS: Under the condition of corneal frostbite, the formation of ice crystals possibly directly damage both the epithelial and endothelial layers. This case report provides valuable insights for future research in ophthalmic emergency medicine.