Rare case of late presentation of acute hydrops in a 65-year-old patient with keratoconus

We report a rare case of late unilateral presentation of acute corneal hydrops in a 65-year-old diabetic patient. The patient was diagnosed with advanced keratoconus in the right eye; the left eye was normal. He presented with acute corneal hydrops after 8 months. An intracameral perfluoropropane injection was given; penetrating keratoplasty was performed 3 months later. This rare late unilateral presentation of acute hydrops in a diabetic individual without predisposing factors questions the concept that progression of keratoconus stabilizes as age increases and also puts into question the protective effect of diabetes on the progression of keratoconus.