Case Report 1 – Terrien’s Marginal Degeneration

Case Report for QUT 4th Year Optometry Students

Things to note:

TMD is rare, bilateral, asymmetric disease, males > females 3:1, 1/3 of all cases carry an inflammatory component, can rupture need to watch corneal thickness, stromal lipid deposits, absence of Bowmans and anterior stromal thinning

Terrien himself saw 3 cases in 30 years of practice. Watch lifestyle as 15% of cases spontaneously perforate. Differentiated from PMD due to vascularisation, lipid infiltration, or corneal ulceration which do not occur in PMD.

  • 23 yo female – soccer player / lawyer –
  • GH – unremarkable – no RA / autoimmune disorder
  • POH – Moderate myopia
  • OD: -3.25 / -0.50 x 61 DS (6/6)
  • OS: -5.00 DS (6/6)

Employ a stepped approach so the simplest option is the best option.

  • J&J One Day Moist
  • OD: 8.5 / 14.0 / -3.50   (6/6)
  • OD: 8.5 / 14.0 / -5.00  (6/6)