Bullous Keratopthy

Bullous Keratopathy

Clinical features:

  • Compromised endothelial cell pump mechanism as the endothelial cell density decreased and decompensated.
  • Can be secondary to congenital endothelial dystrophies, trauma, cataract or other surgical trauma, anterior chamber intraocular lens and prolonged inflammation.
    • Symptoms:
      • Mild to severe decreased vision
      • Painful from epithelial and subepithelial breakdown of the bulla
      • Tearing
      • Sensitivity to light
      • Decrease or loss of corneal sensation in advanced stage
    • Signs:
      • Epithelial and stromal edema
      • Microcysts and bulla formation
      • Subepithelial scarring from resolved chronic edema.

Management:

  • Hyperosmotic sodium chloride 5% drops and ointment.
  • Soft contact lens to control the pain.
  • Intraocular pressure lowering medications.
  • Surgical: penetrating keratoplasty in advanced cases