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In this study we report a structured, evidence-based treatment protocol for ocular surface squamous neoplasia (OSSN) by integrating findings from a systematic literature review with expert clinical insights. We performed a two-step methodology. First, a comprehensive systematic review was conducted using PubMed, Scopus, and Web of Science to identify relevant studies on OSSN treatment. Articles were screened based on predefined inclusion and exclusion criteria. Next, a focused group discussion was conducted with expert ophthalmologists to develop a consensus-driven treatment protocol. Discussions were transcribed and thematically analyzed to identify key recommendations for treatment selection and follow-up strategies. Based on the literature review and expert panel consensus, a structured treatment protocol was developed. Surgical treatment is recommended in cases with uncertainty regarding the diagnosis, resource limitations, exclusive corneal involvement, and poor patient compliance with medical treatment or follow-up. Medical treatment with interferon α-2b or 5-fluorouracil is preferred in other scenarios, with agent selection based on side-effect profile and medication availability. Adjuvant therapy is advised when surgical margins are involved. Furthermore, a standardized follow-up schedule is proposed, ensuring long-term monitoring for recurrence. In conclusion, this protocol provides a structured, adaptable framework for OSSN treatment, offering clear guidelines for selecting the appropriate treatment strategy. By balancing evidence-based recommendations with clinical considerations, this protocol aims to optimize patient outcomes.