This review describes the clinical features of PMD, its differential diagnosis and various management strategies presently available.Ĭopyright © 2010 British Contact Lens Association. 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. Topographical keratoconus classification (TKC) value (in red, bottom of center column) KC3 (A). In rare cases, patients may present with a sudden loss of vision and excruciating ocular pain due to corneal hydrops or spontaneous perforation. Pentacam images showing pellucid marginal degeneration. Pellucid marginal corneal degeneration (PMD) is a rare ectatic disorder which typically affects the inferior peripheral cornea in a crescentic fashion. It is usually bilateral but may be asymmetric. Clinically, PMD patients are typically asymptomatic, except for slow, progressive reduction in visual acuity refractory to spectacle correction. Visual signs and symptoms include longstanding reduced visual acuity or increasing against-the-rule irregular astigmatism leading to a slow reduction in visual acuity. Terrien marginal degeneration is a painless, slowly progressive thinning of the peripheral corneal stroma. Pellucid marginal degeneration (PMD) is a bilateral, noninflammatory ectatic disorder similar to KC. Although it is atypical and rare, clinicians should learn how to identify pellucid and screen patients for it preoperatively, said Yaron S. 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. Pellucid marginal degeneration is a subtle condition that could lead to corneal ectasia following laser eye surgery. 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. Pellucid marginal corneal degeneration (PMD) is a rare ectatic disorder which typically affects the inferior peripheral cornea in a crescentic fashion.
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