An unusual presentation in pellucid marginal degeneration

Abstract

Spontaneous and unilateral corneal perforation in pellucid marginal degeneration is rare and has no clear-cut management protocols, although multiple treatment strategies have been described in the literature with variable outcomes. We report a case of spontaneous corneal perforation in a 64-year-old patient with normal corneal thickness, which was managed with primary suturing and compression sutures that helped not only in the acute management of the disease but in the improvement of corrected distance visual acuity by topographic regularization. Another unusual feature seen in this case is only unilateral presentation, with the fellow eye being completely normal in an elderly patient.