Hydrops

[wanderer]

I'm aged 65 and I've had KC in my right eye since 1993 and in my left eye since 2000. The vision in my left eye is still correctable by a spectacles lens with a balance lens for my right eye which has had no effective vision since 2003. On 4 March I became aware of a blurring in my right eye and this was the beginning of hydrops. I was seen in hospital as an emergency the same day and I was prescribed a two-week course of steroid drops and sodium chloride drops to manage my eye for possible swelling and infection.

Since then I've had no pain in my right eye or irritation or infection and the cloudiness is minimal having neither increased or decreased since I first noticed. I would really appreciate any advice that there may be as to what seems to be a relatively mild hydrops issue and as to its likely outcome. I do have a hospital double appointment in July with an optometrist and an eye consultant. I wonder if I might be offered a corneal transplant at what seems to be an early stage in hydrops and if so would this be usual?

[longhoc]

Hi Wanderer and welcome to the Forum !

Typically, an incidence of hydrops -- even if it seems quite severe -- is left to heal before any consideration of whether or not a graft is indicated is made by the ophthalmologist. There's several reasons for this approach including a) attempting a graft on an cornea which is recovering from a trauma isn't the best starting point so leaving it to heal is safest and b) on occasions, the hydrops healing may improve vision or corneal shape.

What'll probably happen then is that you'll be monitored in the clinic regularly until your cornea has healed and cleared. Then you'll be assessed again and a decision made if a graft is something that should be considered. It'll usually take 8 to 12 weeks to get to that decision point, maybe a little longer.

Bit annoying that you've had a lifetime of Keratoconus and only now at 65 does it misbehave !

Anything else you need to know, do ask.

Take care, and best wishes

Chris

[Anne Klepacz]

Hello Wanderer and welcome to the forum,
Most consultants will wait to see how a hydrops resolves itself before deciding on the next step. So I'd think it unlikely that you'd be offered a corneal transplant at this stage, though I guess with a mild hydrops, the outcome could be obvious 3 months on. You'll find a good article about hydrops on the home page of this website - I think it's under the heading of 'articles from the clinic' or something similar. Sometimes vision can actually improve after a hydrops. So it's really a question of waiting until July and seeing what the specialist thinks.
It's good that after the initial pain and blurriness, things seem to have settled down quickly. All the best, and let us know how you get on.
Anne

[wanderer]

Thank you for your replies, I really appreciate the guidance. Would there be any circumstances in which the hydrops would not resolve and the cloudiness not disperse?

[dalbeath]

Hello Wanderer,
Please do not despair. I had a perforating hydrops in my left eye in Jan 2012. It looked like a distorted marble. Just a huge opaque bulge and I had no vision at all. Surgeon said I definitely needed a graft but wanted to wait until the scar tissue had formed as it was very close to edge of cornea. 3 months later I started to see vague lights, one month later odd dark shapes, and now with a semi scleral lens I have 20/20. I still have 3/20 without the lens so struggle a little but I managed to escape a graft.
The scar healed across my eye and corrected a lot of the distortion.
Good luck
Wendy

[wanderer]

Wendy, thank you very much for your reply. I'm glad you had such a good outcome from what must have been a really worrying situation for you.

I don't feel I'm despairing as such as my situation is relatively minor, but I do feel like I'm in limbo. My corneal oedema - hydrops has not changed at all since I first noticed it as a vague cloud on 4 March, it's still there and I do wonder when it will resolve. My hospital double appointment has been put back to 1 August. Is there anything I should make a mental note to ask then? Specifically, is there anything that can minimise the oedema and help nature along that I could ask for?

[dalbeath]

Mine was obviously a bit more severe and I had my eye secured shut for 6 weeks.
But I would not advise that unless you have to as pretty horrible.
I think you just have to wait
Good luck !