bilateral terrien’s marginal degeneration, total peripheral corneal ectasia and posterior polymorphous dystrophy in a patient with rheumatoid arthritis

purpose: to report bilateral terrien’s marginal degeneration, circumferential peripheral corneal ectasia and posterior polymorphous dystrophy in a patient with rheumatoid arthritis. case report: a 24-year-old male patient, who was known case of rheumatoid arthritis from 8 years before, presented with decreased vision since four years ago. comprehensive ophthalmic eye exami-nation revealed bilateral circumferential peripheral corneal thinning and bulging with vascularization and lipid deposition in addition to band-like lesions in descemet's membrane. previous records revealed no gross abnormalities up to four years ago. corneal lesions were consistent with bilateral circumferen-tial terrien’s marginal degeneration concomitant with posterior polymorphous dystrophy. conclusion: to our knowledge, this is the first report of concomitant bilateral terrien’s marginal degeneration with total peripheral corneal ectasia and posterior polymorphous dystrophy in a patient with rheumatoid arthritis. circumferential involvement, younger age at presentation and bilateral total peripheral corneal ectasia in this case are not typical for classic terrien’s marginal degeneration. the underlying rheumatoid arthritis may have aggravated the condition leading to this atypical and severe presentation of terrien's marginal degeneration.