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Ophthalmic Images
April 9, 2020

Acute Corneal Hydrops in a Young Man

Author Affiliations
  • 1Department of Ophthalmology, New Zealand National Eye Centre, University of Auckland, Auckland, New Zealand
JAMA Ophthalmol. 2020;138(4):e190960. doi:10.1001/jamaophthalmol.2019.0960

A 22-year-old man of Māori ethnicity with a history of keratoconus and atopy presented with sudden-onset reduced visual acuity in the left eye. His best-corrected visual acuity was 20/30 OD and counting fingers OS. The left cornea exhibited a large break in the Descemet membrane, with severe stromal edema extending 360° to the limbus (Figure). Early stromal neovascularization was visible inferiorly. By 3 months, the edema had resolved peripherally, but despite treatment with eyedrops of prednisolone acetate, 1%, 4 times a day, the peripheral deep stromal neovascularization had progressed. Acute corneal hydrops is the occurrence of corneal edema following a break in the Descemet membrane and endothelium.1

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