A 20-year-woman with bilateral keratoconus developed acute hydrops of her right cornea. The amount of corneal oedema progressively increased over eight weeks while the central cornea thinned. Histologically the cornea contained a stromal pseudocyst that was in continuity with the anterior chamber through breaks in Descemet's membrane. Pseudocyst formation is a rare complication of acute corneal hydrops that can simulate severe corneal ectasia.
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