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Bilateral Keratoconus and Corneal Hydrops Associated with Eye Rubbing in a 7-year-old Girl
Mahmoud-Reza Panahi-Bazaz1, Farideh Sharifipour1, Alireza Moghaddasi1
1Department of Ophthalmology, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
Insights
Eye rubbing in children with vernal keratoconjunctivitis (VKC) can lead to corneal hydrops, a serious complication. This case highlights the role of mechanical trauma in childhood keratoconus progression.
Area of Science:
- Ophthalmology
- Pediatric Ophthalmology
- Corneal Diseases
Background:
- Vernal keratoconjunctivitis (VKC) is a common allergic eye condition in children.
- Keratoconus is a progressive thinning of the cornea, often associated with allergic eye disease.
- Corneal hydrops is a rare but severe complication characterized by stromal and epithelial edema.
Observation:
- A seven-year-old girl with a history of VKC and asymmetric keratoconus presented with bilateral corneal hydrops.
- The hydrops developed subsequent to habitual eye rubbing.
- Corneal edema resolved spontaneously over 9-16 weeks, leaving corneal scarring.
Findings:
- Continuous mechanical trauma from eye rubbing is implicated in the pathogenesis of keratoconus.
- Eye rubbing can precipitate corneal hydrops in pediatric patients with underlying keratoconus and VKC.
- Corneal scarring is a sequela following resolution of hydrops.
Implications:
- Ophthalmologists should be vigilant for keratoconus in children with VKC, especially those who rub their eyes.
- Patient education regarding the detrimental effects of eye rubbing is crucial in managing VKC and preventing keratoconus complications.
- Understanding the role of mechanical stress may inform future therapeutic strategies for keratoconus.
Purpose:
To report a young child with bilateral keratoconus in the context of vernal keratoconjunctivitis (VKC) who developed bilateral corneal hydrops associated with eye rubbing, and to discuss the pathogenesis and review the pertinent literature.
Case Report:
A seven-year-old girl with VKC and asymmetric keratoconus developed corneal hydrops due to habitual eye rubbing. Corneal edema subsided within 16 weeks in her right eye and 9 weeks in the left eye with subsequent corneal scarring.
Conclusion:
Continuous mechanical trauma, such as eye rubbing, plays a significant role in the pathogenesis of keratoconus and subsequent hydrops even in childhood.
