Corneal hydrops is an uncommon condition occurring in 2%−3% of patients with keratoconus. It is caused by a leak of aqueous into the cornea through a tear in Descemet's membrane causing severe corneal edema (Fig 1). Acute hydrops occurred in a 51-year-old man. The hydrops resolved over 4-months with conservative medical treatment, and a penetrating keratoplasty was performed. The histopathology (hematoxylin and eosin and periodic acid-Schiff) revealed thinning of the apical stroma (Fig 2, asterisk), breaks in Bowman's membrane (Fig 3, white arrow) and subepithelial bullae (Fig 4, open arrow).
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