The CMGs offer information on the diagnosis and management of a range of conditions that present with varying frequency in primary and first contact care.
Corneal hydrops is a rare complication of primary corneal ectasias including keratoconus, keratoglobus and pellucid marginal degeneration in which aqueous humour enters the cornea, leading to corneal oedema. It is usually the result of the rupture of Descemet’s membrane due to corneal thinning. This Clinical Management Guideline outlines the aetiology, signs, symptoms and evidence-based recommendations for diagnosing and treating corneal hydrops. It summarises the pharmacological treatment options and describes when referral may be appropriate.
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What is corneal hydrops?
This is a rare complication seen in people in whom the cornea (the clear window of the eye) is thinned and distorted, for example in the condition known as keratoconus. Usually for no apparent reason, the back membrane of the cornea splits, allowing fluid from within the eye to flood into the cornea which becomes waterlogged and loses its clarity. The vision may be badly affected.
How is corneal hydrops managed?
Corneal hydrops usually recovers by itself over a period of 2-4 months. Contact lenses should not be worn during this period. If there is any complication in the recovery period, for example if new blood vessels appear in the cornea, patients are quickly referred to the ophthalmologist for specialist treatment.
These patients are usually wearing contact lenses to correct their vision because glasses do not help very much. The lenses may need to be refitted when the condition resolves, because of a change in shape of the eye.