Managing the unexpected complications of a chronic eye condition

Patient Profile:

Age: 37

Gender: Male

History: 24 years living with keratoconus

keratoconus treatments in tampa, floridaA 37-year-old man, who had been living with keratoconus for 24 years, contacted Dr. Berger at Bay Area Eye Institute on a Saturday morning. He was experiencing sudden blurred vision, eye pain, and swelling in his right eye, which had started overnight.

Initial Examination:

Visual Acuity: Could only see hand movements in the affected eye without glasses

Detailed Eye Exam:

– Slight swelling in the upper eyelid

– Redness in the white part of the eye

– Small scratch on the front surface of the eye

– Swelling in the cornea with tiny blisters

Diagnosis and Immediate Treatment

He was diagnosed with acute hydrops, a sudden worsening of keratoconus, along with ruptured blisters on the cornea. He was prescribed:

Cyclogyl: Eye drops, three times a day in the right eye to relieve pain and relax the eye muscles.

Besivance: Antibiotic eye drops, three times a day in the right eye to prevent infection.

He was also scheduled for a follow-up appointment on Monday.

hydrops tampaUnderstanding Acute Hydrops

Acute hydrops is a complication that can happen in the advanced stages of keratoconus. It usually affects people between the ages of 20 and 40, and men are about twice as likely to get it compared to women. It happens when the cornea (the clear front part of the eye) stretches too much and develops a tear. This tear allows fluid from inside the eye to leak into the cornea, causing sudden and painful swelling.

keratoconus OCT scan tampaManaging Acute Hydrops

Most cases of acute hydrops improve on their own within 2 to 4 months. Treatment usually focuses on relieving symptoms and preventing infection:

– Eye pressure-lowering drops

– Saline solution to reduce swelling

– Eye drops to keep the pupil open and reduce pain

– Steroid eye drops to reduce inflammation

– Antibiotic eye drops to prevent infection

Possible Surgical Treatments

Sometimes, surgery might be needed if the condition doesn’t improve with the usual treatments. Surgical options include:

Air/Gas Injections: Injecting a tiny bubble of air or gas into the eye to help reattach the torn layer of the cornea.

Sutures: Using stitches to bring the torn layer of the cornea back together.

Cornea Transplants: Replacing the damaged part of the cornea with a healthy donor cornea. This can be a partial or full-thickness transplant, depending on the extent of the damage.

– Endothelial Keratoplasty: DMEK or DSAEK

Penetrating Keratoplasty (PKP)/Deep Anterior Lamellar Keratoplasty (DALK):May be used in resolved hydrops with visually significant scarring.

Preventative Measures

To prevent acute hydrops, early treatment with a procedure called corneal cross-linking can be done. This procedure strengthens the cornea and stops keratoconus from getting worse.


This case shows how important it is to diagnose and treat complications from keratoconus quickly. With the right combination of treatments, patients can find relief and maintain their vision. Regular check-ups and early intervention are crucial to preventing severe complications like acute hydrops.

Meet Bay Area Eye InstituteEye doctor in Tampa, Florida

Craig Berger, MD opened the Bay Area Eye Institute in Tampa, Florida in 2007, specializing in the treatment of eyelid conditions and diseases, dry eye disease, corneal conditions, cataract and cornea transplant surgery.

Along with Dr. Berger, Doctors Gamell, Kerris and Kudryk, treat and manage eye and eyelid conditions and diseases at Bay Area Eye Institute every day. They accept most health insurances and will accommodate quick new-patient appointments.

The practice focuses on patient satisfaction. Their philosophy is to put the patient first, provide physical and emotional comfort, and strive for the highest care possible. Your time and comfort are paramount. They feel that patient education is an important aspect of treatment and will take the time to explain ocular conditions and treatment plans.

At Bay Area Eye Institute, they employ state-of-the-art technology and careful testing is conducted to tailor treatment and management of your eyelid condition. They utilize the most modern surgical techniques and technology for eyelid surgery.

Bay Area Eye Institute is conveniently located in north Tampa and is easy to get to from all Tampa Bay area counties. They are open 8:00 a.m. to 5:00 p.m. on Monday- Friday. Call them today and ask about setting up an evaluation with Dr. Berger.

Call today!  (813) 265-6940