An 84-year-old woman presented to us with complaints of a mass lesion on the left eye for 6 months. Her left eye exhibited a papilliform lesion spanning the 6 to 9 o’clock positions, measuring 8 mm × 5 mm × 3 mm. No keratin was noted, but feeder vessels were present. Anterior segment optical coherence tomography (AS-OCT) showed an abrupt transition from normal to abnormal epithelium with epithelial hyperreflectivity, thickening, and back‑shadowing. She had no regional lymphadenopathy. Her viral screening was negative, and she had no other systemic diseases. A diagnosis of OSSN was made, and she was started on 5-FU drops four times a day for 1 week in the left eye followed by a drug holiday of 3 weeks. Simultaneous lubricants were prescribed four times a day for 1 month.