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Acute corneal hydrops mimicking full thickness perforation
S W Ch'ng1, M B Pillai, S Aazeem
1Ophthalmology Department, Abertawe Bro Morgannwg University Health Board, Swansea, UK. wcsw81@gmail.com
BMJ Case Reports
|May 19, 2012
Summary
Corneal hydrops in keratoconus can mimic perforation. Prompt conservative management, like bandage contact lenses, aids healing and visual recovery in these cases.
Area of Science:
- Ophthalmology
- Corneal Diseases
- Keratoconus Management
Background:
- Keratoconus is a progressive thinning of the cornea.
- Corneal hydrops, a rare complication, involves edema and breaks in Descemet's membrane.
- Distinguishing hydrops from perforation is critical for appropriate treatment.
Observation:
- A 26-year-old female with keratoconus presented with acute eye pain and redness.
- Slit lamp exam revealed a Descemet's membrane break with iris prolapse and a variable stromal cyst.
- The presentation mimicked a full-thickness corneal perforation due to intermittent epithelial leakage.
Findings:
- Conservative management with a bandage contact lens and taped eyelid was initiated.
- The anterior chamber reformed, and the iris prolapse resolved.
- Descemet's membrane healed, and visual acuity improved significantly.
Implications:
- Corneal hydrops can present as a perforation, necessitating careful diagnosis.
- Conservative treatment is effective for resolving corneal hydrops.
- Early identification and management improve visual outcomes in keratoconus complications.
