title: Corneal Ectasia and Hydrops in Ocular Hypotony: The Corneal Crease.
abstract: OBJECTIVE
  To report the association of chronic ocular hypotony with the development of progressive corneal ectasia and hydrops.
  
  
  METHODS
  Retrospective case series.
  
  
  RESULTS
  Three patients with ocular hypotony were referred for corneal evaluation and found to have ectasia and acute corneal hydrops in their hypotonous eye(s). Clinically, the globes were easily deformable with either external digital palpation and/or simple blinking. All 3 patients had a history of chronic iridocyclitis, including one with juvenile idiopathic arthritis. In each case, the area of thinning was narrow and arcuate in configuration, distinctive from other ectatic disorders. Also uncharacteristically, the acute hydrops resolved rapidly within 2 to 3 weeks without surgical intervention. In 1 case, severe thinning with perforation occurred requiring urgent penetrating keratoplasty.
  
  
  CONCLUSIONS
  This case series demonstrates a unique clinical entity in which corneal ectasia and hydrops developed in the setting of ocular hypotony and easily deformable corneas, in a pattern unlike previously described forms of ectasia. Acute hydrops, even with associated corneal perforation, demonstrated a short and self-limited course. Corneal ectasia and irregular astigmatism should be suspected as a cause of unexplained visual loss in the ever-increasing number of patients with chronic, stable ocular hypotony. Further study is warranted to determine the pathophysiology of corneal ectasia in this setting, which may include mechanical and inflammatory factors.
authors.affiliation: Department of Ophthalmology, University of Illinois at Chicago, Chicago, IL.
authors.forename: Asim V
authors.initials: AV
authors.lastname: Farooq
authors.forename: Ketki
authors.initials: K
authors.lastname: Soin
authors.forename: Samantha
authors.initials: S
authors.lastname: Williamson
authors.forename: Charlotte E
authors.initials: CE
authors.lastname: Joslin
authors.forename: Maria S
authors.initials: MS
authors.lastname: Cortina
authors.forename: Elmer Y
authors.initials: EY
authors.lastname: Tu
mesh_terms: D000328:Adult; D001251:Astigmatism / Q000209:etiology; D002908:Chronic Disease; D015715:Corneal Edema / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D004108:Dilatation, Pathologic / Q000209:etiology; D058447:Eye Pain / Q000209:etiology; D005260:Female; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology; D015948:Keratoplasty, Penetrating; D008297:Male; D015814:Ocular Hypotension / Q000150:complications*; D012189:Retrospective Studies; D014786:Vision Disorders / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D014792:Visual Acuity / Q000502:physiology