Scanning slit topography: diagnostic boon in presumed unilateral Terrien's marginal degeneration.

PURPOSE: To describe the scanning slit topography in two children with presumed unilateral Terrien's marginal degeneration.

METHODS

Two girls aged 9 and 12 years presented with redness and reduced vision in their right eyes. The younger patient had scarring adjacent to the superior limbus, with vessels coursing across, and lipid deposition. Visual acuity improved to 20/20 from 20/400 with +1.0 -3.5×90°. The older patient had similar features inferiorly. Her visual acuity improved to 20/20 from 20/40 with -3.5×65°. Their left eyes were normal. A diagnosis of unilateral Terrien's Marginal Degeneration (TMD) was made.

RESULTS

Scanning slit topography (Orbscan II™, Orbscan Inc., Salt Lake City, UT) of the right eyes revealed high against-the-rule astigmatism. The left eyes showed elevations of anterior and posterior corneal surface above the best-fit-sphere, skewing of principal meridians and increased astigmatism from 3.0 to 5.0mm zones. Based on these findings bilateral asymmetric TMD was diagnosed.

CONCLUSION

Though the diagnosis of TMD is mainly clinical, scanning slit topography findings in TMD have not been described earlier and are useful in establishing the diagnosis of bilateral asymmetric TMD.