Hydrops, a Complication of Keratoconus
Hydrops are a rare complication of Keratoconus (KC) and other corneal ectatic disorders.
The term hydrops is a term used to denote an abnormal accumulation of body fluid in a tissue or cavity. The condition is caused by a rapid development of corneal edema secondary to a break in the Descemet membrane.
The rupture occurs to the less flexible Descemet’s membrane and as a result, allows an influx of aqueous humour to enter the cornea.
The leakage called aqueous humour is a clear, transparent, watery liquid, like plasma but containing low protein concentration.
When the rapture occurs and aqueous humour enters the cornea, the leakage gives the eye a marble look.
Does It Hurt?
When the Descemet’s membrane tears, or splits, it’s sudden (acute), can be painful and is sometimes followed by a scratchy sensation in the eye.
Although this kind of complication in keratoconus is rare, we should be high tailing it to our KC specialist ASAP, if this happens.
Will We Need A Cornea Transplant?
In most cases a transplant will not be necessary.
If the scare is not central, (in the line of our site) there is a good chance that our vision will not be any worse than before the rupture occurred, after the scare has healed.
On the other hand, unfortunately, if the rupture is more centralized, there’s a high chance our vision will be impacted negatively.
This is when some big decisions will have to be made.
How Long Will It Last?
This is temporary state, and the milkiness will clear up in a few months.
With or without treatment, the condition tends to resolve itself over the course of three or four months as the Descemet’s membrane reseals.
Medication for pain, as well as anti-inflammatory medication can make the recovery process more tolerable.
On the other hand, there’s always the other hand.
Depending on the size of the rupture and whether or not we have an infection, the healing process could take longer.
How Will Our Vision Be After?
After the rupture we will be left with a scar at the site of the original tear. The scar often is not in the center of our vision. If this is the case, there will be little deterioration in our vision.
In fact, there are many cases where vision and the tolerance for wearing contact lenses becomes even better. How is that possible? We have fluid leaking from our eye.
If we understand, what is Keratoconus. We know that our vision problems, in part, stem from the irregular shape of our cornea.
More specifically our cone shaped cornea. When the rupture occurs, the leakage flattens the cornea. It now has a more natural curvature and less of a cone shape, giving us better vision than before the rupture occurred.
For that same reason contact lenses can fit better.
Who is at Most Risk of Developing Complications
We usually associate hydrops with keratoconus.
The rate of developing hydrops is higher in other corneal ectatic disorders like pellucid marginal degeneration and keratoglobus, with some reports being as high as 11%.
As opposed to KC suffers. Where around 3% of us will advance and develop hydrops.
The average age of onset is around 25 years of age.
Males being more commonly affected than females.
History of seasonal allergies and eye rubbing is said to be associated with the development of hydrops.
My Case
I have been living with keratoconus for some time.
I was first diagnosed in the early nineties and underwent a corneal transplant in my right eye in 1996.
My transplant wasn’t due to hydrops. KC was progressing aggressively in my right eye and my cornea was alarmingly very thin.
My practitioner and myself, decided a transplant would be the best course of action to avoid more serious complications down the line.