title: Acute corneal hydrops mimicking full thickness perforation.
abstract: 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.
authors.affiliation: Ophthalmology Department, Abertawe Bro Morgannwg University Health Board, Swansea, UK. wcsw81@gmail.com
authors.forename: S W
authors.initials: SW
authors.lastname: Ch'ng
authors.forename: M B
authors.initials: MB
authors.lastname: Pillai
authors.forename: S
authors.initials: S
authors.lastname: Aazeem
authors.forename: K L
authors.initials: KL
authors.lastname: Tu
mesh_terms: D000208:Acute Disease; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002701:Chloramphenicol / Q000627:therapeutic use; D003261:Contact Lenses; D003316:Corneal Diseases / Q000175:diagnosis* / Q000628:therapy; D003937:Diagnosis, Differential; D004487:Edema / Q000175:diagnosis* / Q000628:therapy; D005260:Female; D006801:Humans; D007640:Keratoconus / Q000150:complications; D014792:Visual Acuity
chemical_list: D000900:Anti-Bacterial Agents; D002701:Chloramphenicol