International Journal of Keratoconus and Ectatic Corneal Diseases
Volume 9 | Issue 1 | Year 2020

Terrien’s Marginal Degeneration: An Uncommon Eye Disease and Treatment Modalities

Ananda Kudari1, Sumangala BR2

1Department of Medical Surgical Nursing, OP Jindal College of Nursing, Bellary, Karnataka, India

2Department of Obstetrics and Gynaecological Nursing, OP Jindal College of Nursing, Bellary, Karnataka, India

Corresponding Author: Ananda Kudari, Department of Medical Surgical Nursing, OP Jindal College of Nursing, Bellary, Karnataka, India, e-mail:

How to cite this article: Kudari A, Sumangala BR. Terrien’s Marginal Degeneration: An Uncommon Eye Disease and Treatment Modalities. Int J Kerat Ect Cor Dis 2020;9(1):11–12.

Source of support: Nil

Conflict of interest: None


Outermost layer of the eye is cornea which is very clear and transparent. Many diseases can affect the cornea in that Terrien’s marginal degeneration is also one of them, and their causes are unknown. But it is associated with other diseases like scleritis, episcleritis, and keratoconus, and this condition can be diagnosed by corneal topography, slit-lamp microscopy, ultrasound biomicroscopy, and scanning-slit topography. Medically, it can be treated by contact lenses and surgically by different types of keratoplasties.

Keywords: Cornea, Degeneration, Keratoconus, Keratoplasty, Slit lamp.


The cornea is the outermost and clear layer of the eyes. Disease of the cornea involves a variety of conditions that affect the vision.1

Terrien’s marginal degeneration is a corneal disease which is an uncommon but distinct variety of thinning of margin of cornea. It results in slowly progressive noninflammatory, asymmetrically bilateral, or sometimes unilateral corneal thinning at peripheral level of eye, and it is associated with neovascularization of cornea, lipid deposition, and sometimes opacification. Degeneration may result in high degree of oblique astigmatism.


The causes of this disease are unknown/idiopathic, but it is associated with other conditions such as scleritis, keratoconus, episcleritis, anterior basement membrane dystrophy, and posterior polymorphous dystrophy.2



Corneal thinning, it can be localized or may involve extensive proportions of the cornea at peripheral area. Degeneration of corneal tissue starts from superiorly with very mild, punctuates below epithelial layer and anterior stromal opacities, and leaves a clear area in between the opacities and also the limbus. After opacification, the development of a superficial, peripheral, and fine vascular pannus will progress over the years to involve subepithelial opacity at the increasing edge.4 The thinning spreads all circumferentially but rarely involves the inferior limbus and also leaves the epithelium intact. Gradually, the central wall will steep, the peripheral wall slopes, and then a yellow line of lipid or fat deposits and appears at the central edge of the furrow called as leading edge of the pannus. Vessels transverse the furrow and will pass beyond it. In rare condition, spontaneous perforation may result. But perforation can result easily with minor trauma. If there is a rupture in Descemet’s membrane, it will result in interlamellar fluid or even a corneal cyst.5


With initial mild disease, patients are asymptomatic in nature, but in advanced disease, the patients exhibit common symptoms like

Less common symptoms are:




Terrien’s marginal degeneration is uncommon corneal disease, and it does not require any medical treatment unless there is a perforation. With the help of contact lenses, we can treat this disease. In case of severe degeneration, surgery can eliminate the symptoms of this disease. Keratoplasty is a corneal surgery to treat the marginal degeneration of cornea.


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