Acute keratoconus: clinical cases

Indrė Rašinskaitė1 , Saulius Galgauskas1,2

1Vilnius University, Faculty of Medicine, Vilnius, Lithuania

2Vilnius University, Faculty of Medicine, Institue of Clinical Medicine, Clinic of Era, Nose, Throat and Eye Diseases, Center of Eye Diseases, Vilnius, Lithuania


Background. Keratoconus is chronic ectatic corneal disease. The progressive thinning of corneal stroma causes corneal cone shape and impaired vision. The etiology of the disease is associated with genetic, environmental factors, allergic and atopic diseases. Keratoconus usually progresses slowly firstly affecting one eye. Acute course of the disease is rare, manifested by acute swelling of the cornea.

Clinical case No.1. 21 y.o. man presented at emergency department with decreasing visual acuity of the right eye. Complaints appeared two weeks ago, during that time he used artificial tears. One week after the onset of symptoms, the patient was consulted by an ophthalmologist and diagnosed with acute right eye keratitis. Swelling of the right corneal stroma, descemetitis was observed during admission to the hospital. Topographic revealed greater corneal curvature in the lower right eye.

Clinical case No.2. 28 y.o. patient with Down syndrome was consulted due to impaired left eye visual acuity, tearing lasting five days. Ophthalmologist observed corneal edema, viral keratitis was suspected and levofloxacin drops and aciclovir tablets were prescribed. During objective examination, a strong swelling of the left corneal stroma, bulls, rupture of the Descemete’s membrane were observed. Keratoconus was diagnosed by corneal topography.

Conclusion. Acute corneal hydrops is a rare complication of keratoconus. The diagnosis of keratoconus is complicated if acute hydrops occurs as the first symptom following eye irritation, pain, photophobia. The main diagnostic method of keratoconus is topography.

Keywords: keratoconus, corneal hydrops, ectasia, corneal topography

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