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Presentation type	E-poster
Title	Acute Corneal Hydrops in Previously Undetected Pellucid Marginal Degeneration: A Case Series

Purpose	Purpose: To present 2 cases of rapidly progressive unilateral corneal thinning and acute corneal hydrops as a presenting sign of pellucid marginal degeneration (PMD).
Methods	Methods: Case series.
Results	Results: Patient 1, a 64-year-old woman, was referred for an acute unilateral decline in visual acuity (VA) and increase in astigmatism in the left eye. Investigation revealed a BCVA of 0.15, a corneal astigmatism of 8D and a peripheral corneal thinning. Seven weeks later, she developed an acute hydrops with positive Seidel’s sign. Patient 2, a 62-year-old woman, presented to her ophthalmologist with an acute decrease in VA and fluctuating refraction in her right eye. This was followed 2 weeks later by the sudden development of a flat anterior chamber (AC). On presentation to our clinic, we noted a BCVA of 0.2, an astigmatism of 7.75D and a corneal hydrops with a positive Seidel’s sign in a region of inferior corneal thinning. Prior to this sudden decrease in VA, both patients had a normal BCVA and were unaware of any ocular pathology. Treatment included bandage contact lens fitting, prophylactic topical antibiotics and oral doxycycline. Over time, both cases showed resolution of edema and closure of corneal defects. Scleral contact lenses improved BCVA to 1.0 in the affected eyes.
Conclusion	Conclusion: This case series emphasizes that a previously undetected PMD can progress after the age of 60 and can present itself as an acute corneal hydrops, leading to corneal perforation and a flat AC. Prompt diagnosis and treatment can lead to full visual recovery.
Conflict of interest	No

Authors 1

Last name	ALLUYN
Initials	L
Department	Dpt of Ophthalmology, Ghent University Hospital, Ghent, Belgium
City	Ghent

Authors 2

Last name	BEIRNAERT
Initials	V
Department	Dpt of Ophthalmology, Ghent University Hospital, Ghent, Belgium
City	Ghent

Authors 3

Last name	ROELS
Initials	D
Department	Dpt of Ophthalmology, Ghent University Hospital, Ghent, Belgium
City	Ghent