Vernal Keratoconjunctivitis Associated with Terrien Degeneration and Intralesional Cysts

A 22-year-old white male with vernal keratoconjunctivitis was referred to us with the diagnosis of concomitant Terrien’s marginal degeneration. Snellen vision was 20/20 in both eyes. Slit-lamp examination revealed in the superior quadrants a large solitary cyst focally replacing the thinned stroma (between 11 and 2 o’clock in OD (Fig. A) and at 11 o’clock in OS (Fig. B), a fine vascular pannus and subepithelial opacity at the advancing edge. Anterior segment OCT (Fig C, D) confirmed the location of the bilateral hyporeflective cysts directly anterior to the limbus (arrows). No change was observed over a three-year follow-up.