A 45-year-old patient presents with a painful peripheral corneal ulcer that begins at the limbus and progresses circumferentially and centrally, with a characteristic undermined, overhanging leading edge. There is no associated scleritis and no systemic vasculitis. What is the most likely diagnosis?
- A Mooren ulcer ✓
- B Terrien marginal degeneration
- C Peripheral ulcerative keratitis associated with rheumatoid arthritis
- D Staphylococcal marginal keratitis
Correct answer: A. Mooren ulcer
Explanation
Mooren ulcer is an idiopathic peripheral ulcerative keratitis with the classic overhanging, undermined edge and absence of scleritis. It progresses circumferentially and centrally. PUK associated with RA shows absent overhanging edge and is often associated with scleritis. Terrien is painless peripheral thinning. Staphylococcal marginal keratitis shows satellite infiltrates separated from limbus by a clear zone.
Reference: AAO BCSC Section 8: External Disease and Cornea, 2022-2023 ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.