Acute corneal hydrops mimicking full thickness perforation
- 1Ophthalmology Department, Abertawe Bro Morgannwg University Health Board, Swansea, UK
- 2Ophthalmology Department, Betsi Cadwaladr University Health Board, St Asaph, UK
- 3Ophthalmology Department, H M Stanley Hospital, St Asaph, UK
- Correspondence to Dr Ch’ng SW,
A 26-year-old Caucasian female with keratoconus presented with an acutely painful and red left eye. Visual acuity on presentation was 3/60. Slit lamp examination revealed localised Descemet’s membrane break with iris partially plugging it. There was a bulging stromal cyst which would intermittently flatten and reform. The appearance when the cyst was flattened mimicked a full thickness corneal perforation. However, no obvious overlying epithelial defect was detected and an intermittent leakage through micro-perforations in the corneal epithelium was the probable cause of the variable appearance. The anterior chamber reformed and iris plug freed following an insertion of a bandage contact lens and taped eyelid. On follow-up, the Descement’s membrane had healed with visual acuity improving to 6/18. Our case illustrates the importance of identifying corneal hydrops mimicking a full thickness perforation as conservative management has a greater chance of recovery.
Competing interests None.
Patient consent Obtained.