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ARTICLES
Year : 1978  |  Volume : 26  |  Issue : 3  |  Page : 30-31

Terrien's marginal degeneration with bilateral total ectasia of the cornea


Maulana Azad Medical College and Associated Irwin and G.B. Pant Hospitals, New Delhi, India

Correspondence Address:
Gurbax Singh
Maulana Azad Medical College and Associated Irwin and G.B. pant Hospitals, New Delhi
India
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Source of Support: None, Conflict of Interest: None


PMID: 738779

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How to cite this article:
Singh G, Malik S. Terrien's marginal degeneration with bilateral total ectasia of the cornea. Indian J Ophthalmol 1978;26:30-1

How to cite this URL:
Singh G, Malik S. Terrien's marginal degeneration with bilateral total ectasia of the cornea. Indian J Ophthalmol [serial online] 1978 [cited 2019 Dec 6];26:30-1. Available from: http://www.ijo.in/text.asp?1978/26/3/30/31195

Duke Elder[1] has described marginal degene­ration of the cornea as a rare bilateral condition with opacification and vascularization of the periphery of the cornea, progressing by degene­ration of the stroma to the formation of a gutter, and finally resulting in ectasia. Evolution of the condition is extremely slow and the development of ectasia may take 10 to 20 years. The condition has been seen to exist more frequently in males than in females (3: 1). The usual feature of this condition is the ectasia above and a furrow below, or localised vesicular ectasia. It is extremely rare to find a total corneal ectasia from marginal degeneration. Francois[2] could find 6 reports of total ectasia while Etzine and Friedman[3] reported one unilateral case resulting from marginal degene­ration.

The aim of the present communication is to report a case of marginal degeneration having bilateral total ectasia of the cornea well documented photographically.


  Case Report Top


25 years old female was first seen in the corneal sur­gery unit of Maulana Azad Medical College and Asso­ciated Irwin & G.B. Part Hospitals in September 1967, She complained of defective vision in both the eyes since the past 3 years. She was a house wife of an army officer. She never had any senous illness in the past.

Inspection of the eyes showed a great increase in the cornea. The ectatic tissue had a flattened apex which was perfectly transparent. When cornea was viewed from front, a circle of altered refraction was visible within the corneal limbus. A shallow groove or gutter ran around the periphery of the cornea having a part of cornea adjacent to scleral limbus as normal [Figure - 1],[Figure - 2],[Figure 3]. The groove was approximately 1.5 mm in width.

The horizontal diameter of the cornea was 12 mm in both the eyes (normal 11.7 mm) 4 The vertical diameter was 11.5 mm (Normal 10.6 mm) in both the eyes. The radius of curvature in horizontal was 6.3 mm in left eye and 6.2 mm in right eye (normal 7.8 mm). In the vertical meridian it was 8.5 mm in left eye and 8.2 mm in right eye (normal 7.7 mm). There was roughly 13D of corneal astigmatism in both the eyes. The axis of astigmatism was 68 degrees. Th: ocular tension was 18.5 mm of Schiotz. Retinoscopy showed irregular shadows and it was difficult to refract the patient.

Slit lamp examination of the cornea showed a normal epithelium. A 1-2 mm shallow groove encircled the whole periphery of the cornea about 1 mm from limbus. The thickness of the cornea on both sides of the groove was normal. Few superficial twigs of limbal vessels were seen to reach the area of the gutter. Anterior chamber appeared deep, although not estimated quan­titatively. The iris and lens was normal. Gonioscopy revealed open angle. Fundus examination was normal.

Corneal sensitivity as tested with the wisp of cotton wool was found normal.


  Investigations Top


The laboratory investigation were non contributory. Patient did not show any progress over the 2 years follow up.


  Comments Top


Although the aetiology of Terrien's marginal degeneration is still unknown but its clinical course is well known to fall into various stages'. The cases of total ectasia with marginal degene­ration reported in literature were unilateral and were commonly seen in males. This case was of interest as it was seen in a female and was bilateral.


  Summary Top


An interesting case of bilateral ectasia resulting from marginal degeneration of cornea is reported in a young female[4].

 
  References Top

1.
Duke Elder, S. S. : System of ophthalmology, London, Kimpton 1964 Vol. VIII Part. II, 909-913.  Back to cited text no. 1
    
2.
Francois, J. 1939, Arch. Ophthal., (Paris) 53, 432, 450, 540, 616.  Back to cited text no. 2
    
3.
Etzine, S.: Friedman 1963. A. Marginal dystrophy of the Cornea., Am, J. Ophth., 55, 150.  Back to cited text no. 3
    
4.
Duke Elder, S. S. 1943, Textbook of Ophthal. London Kimpton 2, 1996.  Back to cited text no. 4
    


    Figures

  [Figure - 1], [Figure - 2]



 

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