Corneal hydrops induced by Bell's paralysis in a case of corneal ectasia

An 18-year-old male patient presented with suddenly decreased vision, itching, corneal edema and an inability to close the left eye. He had left Bell’s paralysis for two weeks and used high diopter glasses for five years. The best corrected visual acuity was 0.4 in his right eye and counting fingers in the left eye. Biomicroscopic examination revealed thinning and steepening of the cornea in the right eye and anterior protrusion of the cornea, stromal edema and punctate disruption of the epithelium in the left eye. Topographic image of the right eye was consistent with keratoconus. Six months later, stromal edema gradually regressed and a corneal scar ensued. This case presentation emphasizes that Bell’s palsy may induce disease progression in a patient with preexisting corneal ectasia and results in corneal hydrops.