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November 1963

Marginal Degeneration of the Cornea With Perforation

Author Affiliations

San Francisco
Medical Director Chief, Ophthalmology, US Public Health Service Hospital, 15th Ave and Lake St.

Arch Ophthalmol. 1963;70(5):610-615. doi:10.1001/archopht.1963.00960050612006

Introduction  Marginal degeneration of the cornea, also identified as peripheral furrow keratitis by Gifford,1 senile marginal atrophy by Fuchs,2 and ectatic corneal dystrophy by Terrien,3 is infrequently encountered in practice. Its exact incidence is difficult to ascertain as there are many clinical variants, and some of the milder cases may be easily overlooked. One unusual complication of this relatively benign disease is spontaneous perforation of the cornea. Francois4 found this to be present in 15% of the 130 cases with this diagnosis reported in the literature prior to 1936. Recently six patients were observed in varying stages of marginal degeneration. Surprisingly, in four of these patients there was a corneal perforation evidenced either by iris incarceration in the wound and resultant pupillary distortion, or prolapse of a nubbin of iris through the perforation.

Report of Cases 

1. Marginal Degeneration.  —Early stage, 1; age 72; white male.

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