Do you feel like your vision is slowly deteriorating? Sometimes you can't see clearly even with glasses? Then this is something that may be important to you. This is actually a relatively rare eye condition, but it's worth being aware of.
What exactly is Pellucid Marginal Degeneration?
Simply put, Pellusic Marginal Degeneration, or PMD for short, is a condition that affects the cornea, the clear, round part at the front of your eye. It progresses slowly. You know, a healthy cornea is what helps us see the world clearly. It's like the lens of a camera.
In PMD, a part of the cornea, specifically near the lower edge of the cornea, becomes thinner in the shape of a crescent moon. Think of a clock. This thinning usually occurs in the area between the 4th and 8th hands of the clock. The part of the cornea above this thinning bulges forward, in other words, it becomes elliptical. Because of these changes, the light rays entering the eye are not focused properly. We call this astigmatism. Over time, this can cause your visual acuity to gradually decrease.
Most of the time, PMD affects both eyes. But sometimes it can affect just one eye. The good thing is that it doesn't cause scarring of the cornea. That's why the cornea remains transparent (the word `pellucid` means "clear").
Because PMD develops very slowly, you may not have any symptoms at first. But as the cornea continues to thin and bulge forward, the astigmatism increases. That's when your vision gradually worsens. This can make it difficult to do your daily activities.
Who is most affected by this condition? How common is it?
PMD can affect anyone, regardless of race or ethnicity. However, some studies have shown that it is more common in men. It is usually diagnosed in people in their 20s, 30s, or 40s. However, it can also be diagnosed in people in their 50s or even later.
There are no exact statistics on how common it is. However, it is not as common as keratoconus, another condition that affects the cornea (in which the cornea bulges forward into a cone shape). Keratoconus is estimated to affect between one in 400 and one in 2,000 people. So PMD is a slightly rarer condition.
What are the symptoms? How do you recognize it?
The main symptom of PMD is a gradual deterioration of vision over time. This is due to the increasing astigmatism. Most people do not experience eye pain or other specific symptoms.
However, very rarely, PMD can cause a serious complication called acute corneal hydrops. This is when the cornea suddenly swells, causing blurred vision and sensitivity to light. Some people may also experience severe pain. This is an emergency.
Why is this happening? What is the reason?
In fact, researchers have yet to find a definitive cause of PMD or any risk factors, so it's hard to say exactly why it happens.
How do doctors diagnose this? What tests do they do?
Your eye specialist (ophthalmologist) can diagnose PMD. He or she will examine your eyes, perform various tests, and ask you about your symptoms, especially whether you have been experiencing vision loss for a long time.
The main test used to diagnose this condition, and considered the "gold standard," is called corneal topography. This is a quick, painless test. All you have to do is sit in front of a machine. The machine takes pictures of your eyes and creates color-coded maps of the surface of the cornea. It's like a map showing the elevation of a mountain. The eye doctor studies these maps to learn about the shape and curvature of your cornea.
A corneal topography map of someone with PMD can sometimes show "kissing doves" (like two doves kissing) or "crab claws" (like a crab claw). These maps show areas of the cornea that are sharply curved, or protruding, in red. These maps are used by your doctor to determine whether you have PMD or another condition that affects the cornea (corneal ectasia).
What are the treatments for this?
Treatment options depend on the severity of your condition and how far it has progressed. In the early stages, you may be able to use glasses or contact lenses to improve your vision. There are different types of contact lenses. Your eye doctor can help you choose the type that best suits your condition.
The most important thing is that even though you may see better when you wear contact lenses, it will not stop the condition from getting worse.
Therefore, if your vision is not good enough to do your daily activities with glasses or contact lenses, you may eventually need surgery. Surgery involves removing the damaged part or all of your cornea and replacing it with healthy corneal tissue from a donor. There are also different surgical procedures for this. Your doctor will explain the pros and cons of each procedure to you.
Is there a way to prevent PMD?
Unfortunately, there's nothing you can do to prevent PMD. Because, as we mentioned before, researchers still don't know exactly what causes it.
However, it is important to see your optometrist or ophthalmologist at least once a year for an eye exam. He or she can check the general health of your eyes and detect any problems early. If PMD is detected early, it can be monitored to see how it progresses and plan appropriate treatment.
What can you expect if you have PMD?
Your doctor is the best person to tell you about your condition. PMD does not cause complete blindness. However, as your vision gradually deteriorates, it can have a significant impact on your daily activities. The rate at which the disease progresses varies from person to person. Therefore, lifelong medical advice and follow-ups are necessary to monitor your condition and ensure that your treatment plan is working properly.
How do I take care of myself? How do I take care of my eyes?
If you have PMD or another corneal disease, it is very important to take care of these things:
- Avoid rubbing your eyes. This can, although rarely, cause complications such as corneal hydrops.
- Avoid rubbing your eyes vigorously. This can increase intraocular pressure, which can also cause corneal hydrops.
- If you wear contact lenses, clean them exactly as your doctor has instructed.
- Maintain good eye hygiene. Wash the area around your eyes daily with a mild soap and lukewarm water. Then pat dry with a soft cloth.
When should I see a doctor? What if it's an emergency?
You should usually have an eye exam at least once a year. Sometimes your doctor may ask you to come in for an exam sooner. Be sure to go to all of those appointments.
Also, if you develop any new symptoms or notice any unexplained changes, call your doctor immediately.
What to do in an emergency?
If you have any of the following symptoms, it may be a medical emergency. So call 1990 immediately or go to the nearest hospital emergency department:
- A sudden, severe eye pain.
- Sudden blurred vision or double vision.
- Eye swelling (Edema).
What are the important questions to ask the doctor?
If you've been diagnosed with PMD, it's normal to have a lot of questions on your mind. Discuss all your questions and concerns with your doctor and get the answers you need. For example, you might ask questions like:
- How far has my condition progressed?
- What treatment method is best for me?
- Will I need surgery?
- What should I do to take care of my eyes at home?
- Are there any activities I shouldn't do?
What is the difference between Pellucid Marginal Degeneration (PMD) and Keratoconus?
In the early stages, PMD can look similar to keratoconus (a condition in which the cornea bulges forward into a cone shape). As a result, some people with PMD may be misdiagnosed as having keratoconus, even though they actually have PMD. However, there are several important differences between the two conditions.
Another thing to know is that you can have both PMD and keratoconus. In fact, about one in ten people with PMD also have keratoconus.
Finally, things to remember (Take-Home Message)
Pellucid Marginal Degeneration can affect your daily life and can make you a little anxious about the future. However, take it day by day, and work with your specialist to get the treatment you need. Most people with PMD do not have serious complications. They can manage the condition with glasses or contact lenses. In some cases, surgery may be the best option. Talk to your doctor to learn more about your options and what to expect in the future. The most important thing is to stay calm and follow your doctor's instructions.
` Pellucid Marginal Degeneration, PMD, Cornea, Astigmatism, Vision Loss, Eye Diseases, Corneal Topography, Keratoconus
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