Corneal Hydrops is a nasty complication resulting from Keratoconus. Thankfully, it is a rare one (one site says only 3% of eyes with Keratoconus get it, which makes the prospect of getting it in two eyes pretty remote). It can occur at any time and with no warning, though it is more common among advanced Keratoconus patients (i.e. those unfortunate enough, like me, to have very steep corneas).
A Hydrops occurs when one of the internal layers of the cornea (there are many layers of cells) splits and fluid from the eye enters the cornea. This causes the cornea to swell and become cloudy and white.
Here are some examples of what this will look like. Click here.
Levels of cloudiness vary, but many people have a complete white out of the eye, so it looks like a white marble. This can be quite alarming both for you and others, but you get used to it. You can also get a lot of pain with Hydrops. I have had one in both eyes, two and a half years apart. The first I had no pain with, and the cloudiness was very bad. The second was horrendously painful, but less cloudy.
Obviously, the affected eye is rendered pretty much blind while the condition is at its worst, but your brain adapts quickly to seeing purely through one eye. With the first, I did not miss any time off work because of the condition and I was working as a sub-editor on a magazine, so you can see how quickly you can adapt! However, with the second, I had a day off with the pain, and then two more days off to get used to seeing out of my left eye, which was affected by the scar from the first Hydrops (in certain lights I can see perfectly, in others very poorly, because light hits the scar.)
The most difficult time is actually when you begin to be able to see out of your eye again as it recovers and vision begins to return, as your brain begins to try and use that eye once more. This can make you feel quite dizzy and disorientated. I can recommend a pair of sunglasses with piece of cardboard stuck to the lens that covers the affected eye. An eye patch, basically, but one that does not draw attention to yourself!
There is no real treatment for Hydrops. You just have to sit it out and wait for the swelling to go down and the fluid to drain away. Steroid drops can help reduce the inflamation and sodium chloride drops can help evaporation (apparently). There are other methods people have used that you can read in the comments below, but personally I have found patience to be the best policy. Recovery is down to each case, my left eye is back to full vision with a scleral lens and that took around a year and a half, my right eye is still progressing and that is nearly two years on from the rupture of the cornea. Like everything with Keratoconus, everyone is different. Patience is a must. Despite nothing seemingly getting better for months you can suddenly have a week where your eye gets better massively. These long lows and brief highs were common in my recovery period.
As the eye recovers, you begin to see where the split in the cornea occurred, as the cloudiness recedes into one particular area – the place in which the break in the tissue happened. As with any other cut or tear, a scar is left as a reminder, but in this case it looks like a mini cloudy milky way star collection on your eye ball. If this scar is off the centre of your eye, you are very lucky and vision will probably return to normal pre-Hydrops levels. In some cases, it can be even better, as the healing process from a Hydrops can flatten the cornea, making it easier to fit a contact lens.
If the split is over the centre of the eye, however, then there is nothing you can do with lenses to correct the problem. The scar will inflict itself on your vision by clouding it (this is because you are looking through that Milky Way constellation I was telling you about). You can read in the My Experience tab all about how much/little I can see with my Hydrops.
One thing I can recommend for everyone though, is that you wear dark sunglasses as they reduce the glare and the amount of light entering the eye, making your pupil bigger and the scar less of a factor in your vision.
As the cornea recovers, Scleral lenses can be fitted. These sit on the Sclera (white bit) of the eye and do not touch the cornea, allowing it to heal.
Even though my own Hydrops episodes were major ones, I have been fortunate in that my left eye is now less steep than previously and that, depending on light conditions, I have very good vision from it, much better than before. So, though if you are unfortunate enough to get a Hydrops episode the doctors will probably give you the worse case scenario, don’t get downhearted and stay positive. It might be that you are one of the lucky ones and that it is the best thing that could have happened to you.
Here is my left eye at one month after the hydrops, you will notice that you cannot see the pupil at all and the cloudiness covers the whole of the iris:
Below: My left eye after 14 months, the scar is clearly visible on the right-hand side of the pupil, but has reduced dramatically compared to above:
Below: Left eye after 28 months, scar can be seen lower left of pupil (7 o’clock position on pupil)
Below: My left eye after just over four years
Below: Four pictures of right eye after two days (in the first image the pupil is dilated from eye drops)