STRESS INDUCED TERRIEN'S CORNEAL MARGINAL DEGENERATION
Published 2025 - 29th ESCRS Winter Meeting
Reference: PO280 | Type: Presented Poster & Poster | DOI: 10.82333/rxth-2z25
Authors: Michael Bogocz* 1 , Adrian Smędowski 1 , Dorota Wyględowska-Promieńska 1
1Department of Ophthalmology, Medical University of Silesia,Prof. K. Gibiński University Clinical Center,Katowice,Poland;Department of Ophthalmology, Medical University of Silesia,Faculty of Medical sciences in Katowice,Katowice,Poland
Purpose
To report a case of Terrien marginal dystrophy (TMD) with rapid progression following an acute stress event, examining the potential influence of psychological stress on disease exacerbation and progression
Setting
A 47-year-old female patient with previously stable TMD presented to a tertiary ophthalmology clinic with worsening vision and corneal discomfort in his left eye, temporally associated with a recent significant psychological stress episode
Methods
The patient’s clinical history, including ocular and systemic health as well as recent stress factors, was thoroughly reviewed. Slit-lamp biomicroscopy, optical coherence tomography (OCT), and corneal topography were conducted to assess corneal changes and measure the extent of thinning and neovascularization. Anterior segment photography documented disease progression, and intraocular pressure was evaluated to rule out additional ocular complications. Management options were explored, and conservative treatment with lubricants was initiated, with consideration for surgical intervention.
Results
Examination revealed significant corneal thinning, lipid deposition, and new neovascularization into the peripheral cornea compared to prior visits. The patient reported decreased visual acuity in the affected eye and increased discomfort, which coincided with a recent period of intense psychological stress. Conservative management led to stabilization of symptoms; however, the structural changes were noted to be irreversible.
Conclusion
This case underscores the potential influence of psychological stress on the progression of TMD, a typically indolent corneal dystrophy. The temporal association between stress and disease exacerbation in this patient suggests that stress may act as a modulating factor in TMD. Ophthalmologists should consider psychological stress as a possible factor in the progression of TMD. Further research is warranted to investigate the pathophysiological mechanisms linking stress and corneal dystrophy progression, potentially informing monitoring and management strategies for affected patients.