Corneal hydrops, keratoconus and Down sindrome

case report

Abstract

Objective: To present a clinic case of acute corneal hydrops in a patient with Down Syndrome, without diagnosis of keratoconus at the moment of the evaluation, to describe the treatment and course, focusing on the importance of the relationship between the patient and the physician.    

Case report: A 31-years-old male patient with Down Syndrome referred for presenting corneal protuberance in the right eye. As a clinical record he had myopia, astigmatism and nystagmus. On examination, best-corrected visual acuity of hands movement in the right eye and 1/10 in the left one was documented. The right eye presented conjunctival redness 360°, corneal protrusion accompanied with stromal and epithelial edema with bullae. It was diagnosed as acute corneal hydrops. Topical treatment with fenilefrine + prednisolone , sodium chloride 5%, brimonidine+timolol, and ocular occlusion was indicated. Therapeutic remained for a month with favourable evolution.

Conclusion: The clinical-therapeutic management of a patient with Down syndrome requires not only knowing the presentation of the pathology but also adapting the treatment to the patient and his or her family environment.