Post-Traumatic Hydrops Revealing Subclinical Keratoconus: Case Report

The objective of this study is to present a case of post-traumatic hydrops that unveiled subclinical keratoconus in a pediatric patient. Through this, our intention is to underscore the significance of identifying and addressing acute corneal hydrops after ocular trauma, specifically in individuals with latent subclinical keratoconus

Ophtalmology B departmet at Avicenne universitary hospital, Rabat, Morocco

A 7-year-old child presented with a painful, red right eye after being injured by a tree branch. The child's vision in the right eye was reduced to 1/10th without correction. Clinical examination showed that the right eye had conjunctival redness and swelling of the cornea, with fluid-filled blisters and folds in Descemet's membrane, measuring 3mm in diameter. No abnormalities were found in the front part of the eye. The examination of the left eye was normal.

Based on the clinical presentation, imaging findings, and corneal topography, a diagnosis of acute corneal hydrops revealing subclinical keratoconus was established. Immediate medical treatment was started, including the use of a hypertonic eye drop, a cycloplegic agent, artificial tears, an antiglaucoma medication (dorzolamide), a steroidal anti-inflammatory eye drop, and local antibiotics. Surgery was performed to suture the hydrops and repair the compromised Descemet's membrane. During the follow-up period, it was observed that the visual acuity significantly improved from 1/10 to 8/10 following the implementation of gas-permeable lenses and optical correction. This improvement was observed after the resolution of corneal edema and the formation of stromal scars. These findings emphasize the significance of prompt ophthalmic evaluation in the management of ocular trauma in pediatric patients.

This case highlights the occurrence of acute corneal hydrops, which reveals subclinical keratoconus following ocular trauma in a pediatric patient. The use of imaging techniques such as optical coherence tomography (OCT) and corneal topography played a crucial role in confirming the diagnosis and monitoring the effectiveness of the treatment. Effective management of this condition emphasizes the importance of timely and comprehensive ophthalmic evaluation, particularly in cases of pediatric ocular trauma.