During your examination, you will learn about your candidacy for scleral lenses, including an estimate of out-of-pocket costs. ![]() To learn more about your keratoconus, call ReVision Optometry today to schedule your examination at 619.299.6064 or request an appointment online. Is pellucid marginal degeneration a specialty contact lens disease However, most professionals agree that Pellucid Marginal Degeneration is a unique disease that presents specific challenges with specialty contact lenses. These days, scleral contact lenses are a common and effective treatment for keratoconus, including if your eye doctor diagnosed PMD. Pellucid marginal degeneration is diagnosed by corneal topography. The treatment to restore vision is the same if you have PMD or classic keratoconus: specialty contact lenses with a rigid surface are the gold standard for visual rehabilitation. If your doctor told you that you have PMD, you likely get decent vision with updated eyeglasses and received diagnosis later in life compared to others with keratoconus. PMD is the same thing as keratoconus, just a subclass of it. The fact that some patients have a PMD-type topography in one eye and a more classic keratoconus topography in their other eye, also supports that these are the same disease entity. In other words, most patients with PMD likely had onset of their corneal distortion in the adolescent years despite diagnosis coming much later due to mild symptoms. Since many patients with PMD achieve good vision with eyeglasses with the bulk of the corneal distortion decentered downward out of the line of sight, PMD would often get diagnosed later because vision symptoms often are more subtle. The axial power map showed a typical crab claw pattern (Fig. Many eye doctors and patients incorrectly assumed that the time of diagnosis was also the time of onset. The corneal topography obtained 2.5 years after the initial examination showed that there was almost no progression of the corneal topography in the right eye, but the inferior part of the cornea in the left eye was approximately 100 m thinner than that at the initial visit. But in fact, PMD is often diagnosed later because it tends to impact vision less. Second, PMD supposedly had a later onset in life. Reprocessing an axial topography to tangential view generally uncovers a classic keratoconus pattern for most alleged cases of PMD (Figure 2). Pellucid marginal degeneration (PMD) is usually asymptomatic, except for the progressive deterioration in uncorrected and spectacle corrected visual acuity caused by the irregular astigmatism. ![]() A topography can be viewed as an “axial map” which smooths out data points, or as a “tangential” map which provides a more point-to-point assessment of light bending power. First, the classic “crab-claw” or “butterfly” topography pattern attributed to PMD (Figure 1) was just due to the way the topographical map was viewed. Two factors previously confused eye doctors into believing that PMD and keratoconus were separate eye conditions. Same topography as Figure 1 but under a tangential view.
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