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.


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