5/19/2023 0 Comments Pellucid marginal degneration![]() The condition may also have been previously identified in early European studies under several other names such as pellucid marginal degeneration, , or pellucid marginal dystrophy. The word ‘pellucid’, meaning clear, was first used by Schlaeppi to denote the clarity of the cornea in this condition despite the presence of ectasia. ![]() Pellucid marginal corneal degeneration (PMD) is a rare idiopathic, thinning disorder of the peripheral cornea most usually affecting the inferior quadrant in a crescentic fashion. This review describes the clinical features of PMD, its differential diagnosis and various management strategies presently available. Since patients with PMD make poor candidates for laser vision correction, an awareness of the topographical and slit-lamp features of PMD will be useful to clinicians screening for signs of corneal abnormality before corneal refractive surgery. Several surgical procedures have been used in an attempt to improve visual acuity when spectacles and contact lenses do not provide adequate vision correction. The vast majority of PMD patients are managed using spectacles and contact lenses. In rare cases, patients may present with a sudden loss of vision and excruciating ocular pain due to corneal hydrops or spontaneous perforation. Visual signs and symptoms include longstanding reduced visual acuity or increasing against-the-rule irregular astigmatism leading to a slow reduction in visual acuity. Unless corneal topography is evaluated, early forms of PMD may often be undetected however, in the later stages PMD can often be misdiagnosed as keratoconus. Ocular signs and symptoms of patients with PMD differ depending on the severity of the condition. The prevalence and aetiology of this disorder remain unknown. The condition is most commonly found in males and usually appears between the 2nd and 5th decades of life affecting all ethnicities. This patient will never need to undergo corneal transplant surgery.Pellucid marginal corneal degeneration (PMD) is a rare ectatic disorder which typically affects the inferior peripheral cornea in a crescentic fashion. In addition he has been able to wear his lenses every day with all day lens wear comfortably. His vision has remained at 20/20 with his GVR lenses. Every year this patient has returned to our office for yearly examinations, the latest being today. In 2008, we fit this patient with GVR Scleral lenses which have provided this gentleman with 20/20 vision in each eye. He was also unable to obtain functional vision with eyeglasses. Over these years he tried many different types of contact lenses without success. A number of doctors told him that his only option was to have corneal transplant surgery in both eyes. Over the years he visited a number of major eye institutions and clinics throughout the United States trying to get help. When this patient first visited our office, his visual acuity was 20/800 in each eye. Note in the photo below the protrusion or bulging of the upper portion of this cornea. This patient suffers from a very rare form of keratoconus known as “Superior Pellucid Marginal Degeneration.” This type of corneal ectasia affects the upper half of both of his corneas. The patient in the photo with me lives in the Bahamas and first visited our office in 2008.
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