Interstitial keratitis is a non-ulcerating inflammation of the corneal stroma, characterized by neovascularization and cellular infiltration. The associated thinning and opacification of the corneal stroma ultimately leads to decreased vision, which can be permanent if left untreated. While the exact pathophysiology is not known and may vary depending on etiology, it is generally understood to be a T-cell-mediated immune response to antigens in the corneal stroma. Interstitial keratitis was classically categorized as syphilitic and non-syphilitic keratitis. However, over the twentieth century, syphilis dramatically declined as a cause of stromal keratitis, now accounting for less than 1% of cases [1]. In the United States, rates of congenital syphilis in the United States reached a low of 8.4 per 100,000 births in 2012. However, there has been an increase over the last several years, with over 2000 cases reported in 2020 [2, 3]. The rise of this preventable condition and cause of systemic and ocular morbidity is a grave public health concern. While congenital syphilis is considered the classic cause of interstitial keratitis, herpes simplex virus (HSV) has been found to be the most common etiology [4]. Other viral etiologies include varicella zoster virus (VZV) and Epstein-Barr virus (EBV), while bacterial and parasitic causes include tuberculosis, leprosy, Lyme disease, acanthamoeba, trypanosomiasis, leishmaniasis, and onchocerciasis. Interstitial keratitis in a patient with SARS-CoV-2 has also been reported [5]. Cogan’s syndrome is a rare but established cause of interstitial keratitis, which typically presents bilaterally. It is associated with vestibular abnormalities such as tinnitus, ataxia, nausea, or nystagmus, followed by progressive sensorineural hearing loss. Cogan’s syndrome is a diagnosis of exclusion, and other known infectious and inflammatory entities must be ruled out. It is essential to promptly identify and treat patients with Cogan’s syndrome as they can rapidly sustain irreversible hearing loss [6].