#PELLUCID MARGINAL DEGENERATION ICD 9 TRIAL#

Ophthalmologists and ophthalmic practice have been severely affected by the COVID-19 pandemic.

#PELLUCID MARGINAL DEGENERATION ICD 9 TRIAL#

The patient was advised for a rigid gas-permeable contact lens trial for visual rehabilitation. A diagnosis of unilateral pellucid marginal degeneration (PMD) in RE with subclinical PMD in LE was made. Corneal topography done on Pentacam (OCULUS, Arlington, Washington, USA), revealed inferior thinning with crab-claw pattern in RE and minimal against the rule astigmatism with evolving crab-claw pattern in LE ( figure 2). Anterior segment examination on slit lamp revealed localised thinning in the inferior part of cornea in RE. Autorefraction (TONOREF 3, Nidek) of RE showed distorted and localised crowding of mires in the horizontal meridian (at 4 oвЂ™clock and 8вЂ™o clock radii specifically) indicating asymmetrical steepening with against the rule astigmatism ( figure 1C). Best corrected visual acuity was 1/60 and 6/6 in RE and LE, respectively. Following a routine COVID-19 test which came out negative, the patient visited ophthalmology outpatient department (OPD) for a complete work-up post-systemic stabilisation. A presumptive diagnosis of RE irregular corneal astigmatism suggestive of inferior ectasia was made.

No signs of retinopathy were noted on funduscopy in either eye.

Distant indirect ophthalmoscopy at 50вЂ‰cm showed localised pear-shaped reflex in the inferior half of RE compared with a diffuse bright uniform glow in LE ( figure 1A,B). Bedside assessment of visual acuity (wearing level II personal protective equipment) revealed 1/60 and >6/60 in RE and left eye (LE), respectively. A bedside ophthalmic consultation was sought for a 50-year-old woman with diabetes and hypertension admitted for cerebrovascular accident with a history of gradually progressive painless diminution vision in the right eye (RE) over the past 10 years.

Pellucid marginal degeneration icd 9