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Bullous Keratopathy

by Melvin I. Roat, MD, FACS

Bullous keratopathy is a blister-like swelling of the cornea (the clear layer in front of the iris and pupil).

Bullous keratopathy is most common among older people. Occasionally, bullous keratopathy occurs after eye surgery, such as cataract removal. The swelling leads to the formation of fluid-filled blisters on the surface of the cornea. Eye discomfort, pain when looking at bright lights, and loss of vision can result. The blisters can rupture, causing pain, often with the sensation of a foreign object trapped in the eye, and can further impair vision.

The diagnosis is based on the typical appearance of a swollen, cloudy cornea with blisters on the surface.

Bullous keratopathy is treated by reducing the amount of fluid in the cornea. Salty eye drops (hypertonic saline) can be used to draw the excess fluid from the cornea. Drugs that lower the pressure in the eye are sometimes given. On occasion, soft contact lenses can be used to decrease discomfort by acting as a bandage to the cornea. If vision is reduced or discomfort is significant and prolonged, corneal transplantation (see see Corneas) is often done.