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![]() The condition may also have been previously identified in early European studies under several other names such as pellucid marginal degeneration, , or pellucid marginal dystrophy. The word ‘pellucid’, meaning clear, was first used by Schlaeppi to denote the clarity of the cornea in this condition despite the presence of ectasia. Pellucid marginal corneal degeneration (PMD) is a rare idiopathic, thinning disorder of the peripheral cornea most usually affecting the inferior quadrant in a crescentic fashion. This review describes the clinical features of PMD, its differential diagnosis and various management strategies presently available. 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. In rare cases, patients may present with a sudden loss of vision and excruciating ocular pain due to corneal hydrops or spontaneous perforation. Visual signs and symptoms include longstanding reduced visual acuity or increasing against-the-rule irregular astigmatism leading to a slow reduction in visual acuity. 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. 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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