Corneal Hydrops

What is corneal hydrops?

Corneal hydrops is the medical term for swelling in the cornea of your eye. The swelling happens when a split in a layer of your cornea known as Descemet’s membrane allows fluid in your eye to leak through to an inner layer of your cornea called the stroma.

In addition to the swelling, corneal hydrops can cause an inflammatory response in your eye that may result in a cloudy or hazy spot in your cornea. This cloudiness shows up as a white spot on your eye and can make your vision blurry.

Corneal hydrops typically happens suddenly, so you may also hear the term “acute corneal hydrops.” Corneal hydrops can be a complication of keratoconus or any corneal disease that affects the shape of your cornea. These diseases fall under the term “corneal ectasias”.

Corneal hydrops may get better without treatment, but don’t try to make this decision on your own. Visit your eye care provider, who’ll be able to diagnose the condition and will work with you to find the best way to treat it.

How common is corneal hydrops?

An estimated 0.2% to 2.8% of people who have keratoconus develop corneal hydrops. One figure estimates that keratoconus affects 55 out of each 100,000 individuals in the United States.

Corneal hydrops happens more often in men and people assigned male at birth (AMAB). It usually happens when you’re in your 20s or 30s.

What are the symptoms of corneal hydrops?

Some people with corneal hydrops don’t have symptoms. If you do have symptoms, you may have:

• Vision that gets worse suddenly.
• A hazy white spot in your eye.
• Eye pain.
• Extreme sensitivity to light (photophobia).
• Red eyes.
• Watery eyes.
• Problems with your contact lenses.

What causes corneal hydrops?

Corneal hydrops isn’t something like a cold that you get from another person. Healthcare providers believe that causes of corneal hydrops include:

• Thinning of your cornea.
• Distortion of the shape of your cornea (corneal ectasia).
• Repeatedly rubbing your eyes.

What are the risk factors for corneal hydrops?

Risk factors for corneal hydrops include having:

• A “corneal ectasia” disease, especially keratoconus.
• Atopy (a tendency toward allergies or an extreme immune response).
• Down syndrome.

What are the complications of corneal hydrops?

While you have corneal hydrops, your vision may be impaired.

Having corneal edema (swelling) that lasts for a long time can result in blood vessels growing where they shouldn’t grow (neovascularization).

How is corneal hydrops diagnosed?

Your eye care provider will ask you about your medical history and your symptoms. They’ll do a complete eye exam.

What tests will be done to diagnose corneal hydrops?

Your provider may order other tests, including:

• Anterior segment optical coherence tomography: This test will diagnose corneal hydrops and monitor healing.
• Ultrasound biomicroscopy: This will determine if there’s a split in your Descemet’s membrane.
• Tomography: This will determine your cornea’s shape and thickness.
• Seidel test: This test will determine if aqueous fluid is leaking from your cornea.

How is corneal hydrops treated?

Providers treat corneal hydrops with medication or surgery. You may also need treatment for the underlying disease causing corneal hydrops.

For many instances of small tears with little swelling, providers may recommend using topical medications such as:

• Hypertonic saline, which pulls fluid out of your stroma.
• Steroids to decrease inflammation.
• Medications to reduce eye pressure, if your eye pressure is elevated.
• Antibiotics to prevent infection, if needed.
• Drops that dilate your pupils and ease pain.

Providers may recommend surgery if you have larger tears with more swelling that may result in perforation (holes).

In severe cases, untreated corneal hydrops can cause the growth of abnormal blood vessels in your eye.

Can acute corneal hydrops be prevented?

If you have keratoconus, you may consult an eye care provider to determine if you’re a good candidate for a treatment called crosslinking, which will prevent the progression of your condition and prevent corneal hydrops. However, in some cases, you may not be able to prevent acute corneal hydrops as a complication of keratoconus and other corneal diseases.

If you have seasonal allergies or any other condition that causes itchy or tired eyes, you can reduce your risk by avoiding eye rubbing.

What is the outlook for someone with corneal hydrops?

Your provider can treat acute corneal hydrops. But, in most cases, it’ll result in a corneal scar that may require additional treatments, including surgery.

You’ll need follow-up appointments while you’re recovering and for a time afterward to determine the best plan of action for you.

How do I take care of myself?

Do your best to stop rubbing your eyes. Keep your scheduled eye appointments.

When should I go to the emergency room?

Ask your provider for details on when you should contact them or go the emergency room. In general, you should seek care when:

• You have a loss of vision.
• You have sudden eye pain.
• You have symptoms of an infection like a fever.
• You have unexpected discharge from your eye.

Can you wear contacts with corneal hydrops?

Wearing contact lenses when you have corneal hydrops may be difficult or uncomfortable. Once you find out you have it, you’ll probably need to stop wearing your contacts. You should be able to go back to wearing them after treatment.

A note from Cleveland Clinic

Nearly everyone finds it scary when they suddenly can’t see as well as usual and their eyes hurt. Sometimes sudden eye pain and not being able to see are symptoms of corneal hydrops, a medical term for swelling in your cornea. Corneal hydrops may happen for different reasons, including having keratoconus. Contact an eye care provider right away if you have symptoms of corneal hydrops. Your eye care provider will diagnose why your cornea is swelling and recommend treatments.