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