Medical Subject Headings
Corneal Hydrops; Keratoconus; Cornea; Descemet Membrane; Corneal Edema; Optical Coherence Tomography; Tomography, Optical Coherence, Anterior Segment; Conservative Treatment; Administration, Topical; Administration, Oral; Corneal Transplantation; Middle Aged; African Americans; Case Reports
Abstract
Background: Acute corneal hydrops, a rare complication of keratoconus and other corneal ectatic disorders, is characterized by a break in Descemet’s membrane (DM). The subsequent corneal edema caused by leakage of aqueous into the stroma and epithelium may result in corneal scarring that often reduces visual acuity and may mandate corneal transplantation as resolution. The initial diagnosis is sometimes challenging but can be confirmed with anterior segment optical coherence tomography (AS-OCT). AS-OCT is also useful in deciding treatment regimen.
Case Report: This case report discusses the use of AS-OCT to aid in the diagnosis of acute corneal hydrops in a 40-year-old African American female with keratoconus. AS-OCT images supported treatment with conservative topical and oral therapies to manage the acute hydrops, rather than surgical intervention with intracameral gas injection. The patient’s condition was monitored with serial AS-OCT scans until the ultimate resolution of the DM break and edema.
Conclusion: Acute corneal hydrops in keratoconus can be self-limiting. However, longer duration of edema is correlated with higher risk of complications. Therefore, management should aim at improving patient comfort and stabilizing corneal integrity. AS-OCT imaging is a useful tool in diagnosing acute hydrops, determining an appropriate management plan, and monitoring for improvement.
Recommended Citation
Man MK. Use of Anterior Segment Optical Coherence Tomography to Manage Acute Corneal Hydrops in Keratoconus. Optometric Clinical Practice. 2026; 8(1):30. https://doi.org/10.37685/uiwlibraries.2575-7717.8.1.1049
Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.
Digital Object Identifier (DOI)
10.37685/uiwlibraries.2575-7717.8.1.1049