A 23-year-old male presented with sudden, painful decreased vision in his left eye associated with redness, photophobia, and tearing. He gave history of seasonal allergies and vigorous eye rubbing. On evaluation, visual acuity was hand movements close to face. Slit-lamp biomicroscopy revealed severe ectasia in the inferior cornea with overlying edema suggesting presence of corneal hydrops [Fig. 1a]. Anterior segment optical coherence tomography showed multiple stromal fluid pockets [Fig. 1b].[1] Corneal hydrops is characterized by stromal edema due to accumulation of aqueous humor through a tear in descemet's membrane of the cornea in patients with advanced keratoconus and may need surgical management.[2]
Figure 1.

(a) Anterior segment photograph showing ‘Nipple shaped’ conical projection in a patient of advanced keratoconus. (b) Anterior segment ocular coherence tomography photograph revealing multiple stromal fluid collection pockets in the area of cone
Declaration of patient consent
The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
References
- 1.Basu S, Vaddavalli PK, Vemuganti GK, Ali MH, Murthy SI. Anterior segment optical coherence tomography features of acute corneal hydrops. Cornea. 2012;31:479–85. doi: 10.1097/ICO.0b013e318223988e. [DOI] [PubMed] [Google Scholar]
- 2.Loh IP, Fan Gaskin JC, Sherwin T, McGhee CNJ. Extreme Descemet's membrane rupture with hydrops in keratoconus: Clinical and histological manifestations. Am J Ophthalmol Case Rep. 2018;10:271–5. doi: 10.1016/j.ajoc.2018.04.003. [DOI] [PMC free article] [PubMed] [Google Scholar]
