PURPOSE:

To report a case of long-standing atopic dermatitis and atopic keratoconjunctivitis (AKC) with associated pellucid marginal corneal degeneration (PMCD).

Noninterventional case report.

A 45-year-old man presented with the complaints of frequent change in glass prescriptions over the past 5 years. Erythema, dryness, and scaling were noted over both eyelids and the face. An area of inferior peripheral corneal thinning with ectasia of the normal cornea above it was present. Corneal topography showed the presence of against-the-rule astigmatism with inferior sagging of the horizontal semi-meridians, in both the eyes.

The patient was prescribed treatment for AKC and blepharitis and was advised against eye rubbing.

Eye rubbing seen in atopic ocular conditions like AKC may be a contributory factor in the development of PMCD. A thorough examination and topographical evaluation of ectatic corneas is necessary to ensure that cases of PMCD are not misdiagnosed as keratoconus.