Bullous keratopathy

Author: Nat Pernick, M.D. (see Authors page)

Revised: 1 May 2018, last major update October 2013

Copyright: (c) 2004-2018, PathologyOutlines.com, Inc.

PubMed Search: Bullous keratopathy [title] pathology

Cite this page: Pernick, N. Cornea: bullous keratopathy. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/eyecorneabullouskeratopathy.html. Accessed December 17th, 2018.
Definition / general
  • Injury to endothelium (does not regenerate) which normally pumps fluid out from corneal stroma
  • Leads to chronic edema of stroma and epithelium, subepithelial bullae, pain, eventually diffuse scarring and reduced vision
  • Called aphakic bullous keratopathy if after cataract extraction
  • Causes include:
    • Immunologic rejection of corneal endothelium
    • Fuchs dystrophy
    • Implantation of prosthetic intraocular lens
Microscopic (histologic) description
  • Intraepithelial vesicles
  • Bullae between epithelium and Bowman layer
  • Fewer endothelial cells than normal
  • Increased corneal thickness with loss of normal artifactual clefts between collagen lamellae