Optometrists can always refer patients with Pellucid Marginal Degeneration (PMD) to AVC.
Working at an opticians on a day to day basis means most optometrists do not have access to topographers. This means they are unable to pick up corneal irregularities which often do not present themselves under the slit lamp. Optometrists may have suspicions but if the refraction is stable, there is a good visual outcome. It can feel pointless to make a patient go through the stress of a referral when no treatment is required.
However, if the prescription is changing unusually a referral is required for the diagnosis and because treatment may be required.
Pellucid Marginal Degeneration
One type of degenerative corneal condition is called pellucid marginal degeneration. Occasionally it only affects one eye but is mostly a bilateral condition. It is classified by a clear thinning bilaterally in the inferior and peripheral regions (normally 4 o’clock and 8 o’clock) of the cornea. This typically gives rise to high amounts of against-the-rule astigmatism. This pattern is often described as “kissing birds” or “beer belly”. PMD can be mistaken for Keratoconus (find out more here) and, therefore, needs to be diagnosed using the corneal topography and clinical findings of the inferior peripheral thinning of the cornea.
As with Keratoconus, PMD is a progressive condition. Collagen cross-linking and Intra-stromal collagen ring segments (ICRS) may be indicated to help halt the progression. Advanced Vision Care has been carrying out these surgeries for the last 8 years. The results are truly impressive and has revolutionized how vision can be rehabilitated.