Bullous keratopathy

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Last staff update: 22 December 2020

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PubMed Search: Bullous keratopathy [title] pathology

Nat Pernick, M.D.
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Cite this page: Pernick N. Bullous keratopathy. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/eyecorneabullouskeratopathy.html. Accessed December 7th, 2022.
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
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