Date of last review: Due to be updated

Differential diagnosis

  • Other causes of corneal oedema including Fuchs' dystrophy and infective keratitis

Possible management by Optometrist

Treatment

  • Cease contact lens wear
  • Topical lubricants for symptomatic relief
  • Consider prophylactic topical antibiotic if epithelial surface acutely disturbed by oedema and if secondary infection seems likely to occur
    • Ask if allergic to Chloramphenicol
    • If not, supply Chloramphenicol 1% eye ointment 3 times daily for 5 days
    • If allergic to Chloramphenicol, or pregnant, supply Fusidic acid 1% liquid gel twice a day for 5 days
  • Cyclopentolate 1% 3 times daily until healed
  • Consider padding eye to alleviate symptoms
  • Avoid bandage contact lens (hypoxia may induce corneal vascularisation)
  • Reassess corneal topography on resolution (often less steep after hydrops)

Advice

  • Reassure patient that condition will resolve and may not ultimately affect visual function
  • Review weekly for appearance of vascularisation or other complication
  • Majority of cases resolve over 2-4 months
  • May leave some stromal scarring

Management Category

  • Normally no referral
  • Urgent referral if vascularisation present

Possible management by Ophthalmologist

  • As above
  • Topical steroid
  • Penetrating keratoplasty