CASE REPORTA 30-year-old black man presented with a 4-week history of a foreign body sensation, redness, and pain in his right eye. His left eye was stable. The patient had a history of crack cocaine and injected heroin abuse. He was homeless and admitted to using crack cocaine daily over the past 4 months. He denied any previous contact lens use, trauma, or ocular surgery. He was otherwise quite well with no systemic symptoms, and his general medical history was unremarkable.On examination at our hospital, uncorrected visual acuity was found to be light perception (LP) in the right eye and 20/25 in the ABSTRACTWe describe an unusual case of acquired anterior staphyloma in a patient addicted to crack cocaine. At the beginning of his crack cocaine abuse, he noticed redness and irritation of his eyes. Over the next 4 months, the patient also noticed the onset of decreasing visual acuity in his right eye (OD). Initially, his visual acuity was light perception in OD, and slit-lamp examination revealed a corneal infiltrate with a peripheral perforation and an iris prolapse. The patient was hospitalized to ensure compliance with the prescribed treatment and was advised to undergo therapeutic keratoplasty; however, the patient left the hospital against medical advice and was lost to follow-up for the next 6 months. He returned with complaints of photophobia and the inability to close his right eyelids. At this time, his cornea had developed an anterior staphyloma and required a sclerokeratoplasty. Following surgery, the patient was again lost to follow-up.