Noninfectious peripheral corneal ulceration: Mooren's ulcer or Terrien's marginal degeneration?

The clinical course is described of a 50-year-old white man with bilateral, noninfectious, peripheral corneal ulcerations. After several surgical operations which ultimately restored acceptable vision to his right eye, a peripheral penetrating keratoplasty was performed as a primary procedure in the left eye to eliminate the disease process by excising the ulcerated area. Examination of the ulceration within the corneal button by light and electron microscopy disclosed pathologic features compatible with a diagnosis of a Terrien's marginal corneal degeneration or a Mooren's ulcer. Based on the clinical course and histopathologic examination of this case, and on a review of the literature, this report posits that Terrien's marginal corneal degeneration and the peripheral corneal ulceration described as a Mooren's ulcer may represent different ends of a spectrum of noninfectious peripheral corneal ulceration.