Ocular chrysiasis is a deposition of gold in ocular structures secondary to gold salt therapy, which is primarily used in infectious, rheumatoid and psoriatic arthritis. Gold therapy has become an extremely rare treatment due to the advent of rheumatologic medications with better safety profiles. However, any patient who has undergone gold therapy could potentially have ocular chrysiasis. Therefore, it must be included as a differential in the presence of corneal or lenticular changes in these patients. Additionally, it is important to include ocular chrysiasis as a differential in the presence of crystalline keratopathies. A detailed medical history and thorough ocular examination can assist clinicians in making a correct diagnosis.