Rare case of late acute corneal hydrops in a 35-year-old patient post-corneal collagen cross-linking

This case report describes a 35-year-old male presenting with acute corneal hydrops 10 years after uneventful corneal collagen cross-linking done for keratoconus in the left eye. During the follow-up periods, the patient was noted to have several episodes of severe allergic conjunctivitis with eye rubbing that were treated accordingly, but the patient was noncompliant and progression of keratoconus was suspected on topography. There are no reported cases of acute corneal hydrops in cross-linked corneas. We suspect allergic conjunctivitis and eye rubbing may be a risk factor associated with possible progression of keratoconus after cross-linking.