Differential Diagnosis for Circumferential Thinning of Peripheral Cornea
Single Most Likely Diagnosis
- Terrien's Marginal Degeneration: This condition is characterized by a non-inflammatory, progressive thinning of the peripheral cornea, often associated with neovascularization within the area of thinning. It typically presents unilaterally but can be bilateral and is more common in males.
Other Likely Diagnoses
- Pellucid Marginal Degeneration: A rare, bilateral condition that causes thinning of the peripheral cornea, often associated with high myopia and astigmatism. Neovascularization can occur but is less common than in Terrien's.
- Mooren's Ulcer: A rare, painful, and potentially vision-threatening condition characterized by idiopathic, inflammatory ulceration of the cornea, which can lead to thinning and neovascularization, especially in the peripheral cornea.
- Peripheral Ulcerative Keratitis (PUK): An inflammatory condition that can cause thinning and neovascularization of the peripheral cornea, often associated with systemic autoimmune diseases.
Do Not Miss Diagnoses
- Scleritis: A severe inflammatory disease that can cause thinning and neovascularization of the peripheral cornea, but it is typically accompanied by significant pain, redness, and systemic symptoms. Missing this diagnosis could lead to severe complications, including vision loss.
- Corneal Melting Syndrome: Associated with rheumatoid arthritis and other autoimmune diseases, this condition can lead to rapid corneal thinning and perforation, which is a medical emergency.
Rare Diagnoses
- Fuchs' Superficial Marginal Keratitis: A rare condition that causes inflammation and thinning of the peripheral cornea, often associated with neovascularization.
- Dellens: Small, rounded or oval excavations at the margin of the cornea, which can be associated with thinning but are less likely to cause significant neovascularization.
- Staphyloma: A bulging of the cornea or sclera due to weakening of the ocular wall, which can occur in the peripheral cornea but is less commonly associated with the specific pattern of circumferential thinning and neovascularization described.