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)