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Early onset unilateral Terrien's marginal degeneration
Sohini Mandal1,2, Gaurav Sachdeva1,2, Ritu Nagpal2
1Ophthalmology, All India Institute of Medical Sciences, New Delhi, Delhi, India.
BMJ Case Reports
|July 20, 2022
Summary
Terrien's marginal corneal degeneration is a rare condition causing progressive vision loss. Early diagnosis and management, even with lubricants and spectacles, can significantly improve visual acuity in young patients.
Area of Science:
- Ophthalmology
- Corneal Diseases
Background:
- Terrien's marginal corneal degeneration (TMCD) is a rare, bilateral, progressive thinning of the peripheral cornea.
- It typically affects middle-aged males but can present in younger individuals.
Observation:
- A male child presented with gradual vision loss and foreign body sensation in the right eye.
- Slit-lamp examination revealed superior arcuate corneal stromal thinning, vascularization, and lipid deposition.
- Scheimpflug imaging showed high against-the-rule astigmatism with a 'reverse crab claw' pattern.
Findings:
- The patient was provisionally diagnosed with Terrien's marginal corneal degeneration.
- No underlying systemic or ocular disease, trauma, or contact lens wear was identified.
- Serological tests for rheumatic diseases were normal.
Implications:
- This case highlights TMCD in a pediatric patient, challenging the typical demographic.
- Prompt diagnosis and management, including refractive correction, can lead to improved visual outcomes.
- Further research into the etiology and management of pediatric TMCD is warranted.
