- Average time to onset of rejection is 3 months.
- Symptoms: usually asymptomatic or minimal symptoms of irritation or blurry vision.
- Signs: elevated linear opacity in transplanted cornea across graft surface, which advances centrally over the course of several days.
- Usually self-limited.
- In this patient, the first appearance of the rejection line was 20 months after a combined allograft lamellar keratoplasty and limbal transplantation for severe corneal scarring following a chemical burn.
- Treatment: topical steroids are indicated because epithelial rejection may be a precursor to a more serious endothelial rejection.