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Early onset unilateral Terrien’s marginal degeneration
  1. Sohini Mandal1,2,
  2. Gaurav Sachdeva1,2,
  3. Ritu Nagpal2 and
  4. Prafulla Kumar Maharana1,2
  1. 1Ophthalmology, All India Institute of Medical Sciences, New Delhi, Delhi, India
  2. 2Dr Rajendra Prasad Centre for Ophthalmic Sciences, AIIMS, New Delhi, Delhi, India
  1. Correspondence to Dr Prafulla Kumar Maharana; drpraful13{at}


A young man in his first decade of life presented with insidious onset, gradually progressive diminution of vision in right eye since 2 months associated with foreign body sensation. Slit-lamp examination revealed superior arcuate band of corneal stromal thinning extending from 9-3 o’ clock. There was associated corneal vascularisation and presence of lipid deposition at the leading edge of the furrow formation with intact epithelium without any apparent signs of inflammation. There was no previous history of ocular or systemic disease, trauma, ocular surgery, collagen vascular disease or contact lens wear. Serological tests for rheumatic diseases did not show any abnormalities. Scheimpflug imaging showed high against the rule astigmatism with a ‘reverse crab claw’ pattern. A provisional diagnosis of right eye Terrien’s marginal corneal degeneration was made. On a 1-month follow-up visit, there was significant symptomatic relief with lubricants alone and with spectacles the visual acuity improved to 20/60 in the right eye.

  • Ophthalmology
  • Anterior chamber

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  • Contributors SM: writing of the manuscript; GS: acquisition ofdata; RN: design; PKM: conception and supervision.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.