Saltzmann's Eye Disease

Salzmann’s nodular degeneration is a rare eye disease that affects the cornea. Various superficial blue-white lumps usually located in the mid-periphery of the cornea characterize the disease. As the disease is uncommon, research proves difficult, and there is little information for non-experts. If experiencing any of the symptoms related with Salzmann’s, the best resource is always be the consultation of a professional, in this case an optometrist.

Causes

• Patients with Salzmann’s disease often have suffered from previous ocular inflammation. The disease is often a late sequela (resulting condition from a previous disease or trauma) to other ocular diseases, such as keratitis, trachoma, scarlet fever and measles. Other causes of ocular inflammation that can precede Salzmann’s disease include corneal surgery, conjunctivitis, contact lens wear and general ocular trauma. As there have been few case studies, the preceding ocular diseases or traumas are merely associated with, not directly linked to, the possible development of Salzmann’s disease.

Symptoms

• The defining characteristic of Salzmann’s disease is the presence of elevated blue-white nodules, most often located in the mid-periphery of the cornea. Most patients are usually asymptomatic, meaning they carry the disease but do not experience symptoms. The most typical complaints are persistent dry-eye sensations, usually burning or grittiness, but there can be more serious symptoms. Depending on the location of the nodules, they can reduce the patient’s vision. More serious symptoms can include pain, photophobia, blepharospasm (twitching) or excessive lacrimation (tearing).

Diagnosis

• During the early stages of Salzmann’s disease, the nodules can be so miniscule that only an eye doctor can detect them. As the nodules swell and multiply, they will be evident without magnification. As the disease progresses, patients are at increased risk for recurrent corneal erosion (RCE). Other eye conditions can have a similar clinical appearance as Salzmann’s nodular degeneration. Therefore, it may be necessary to consult a corneal specialist if the proper diagnosis is elusive.

Treatment

• For the milder dry-eye symptoms, eye drops or artificial tears will be sufficient. Some patients also use contact lenses as bandages over the entire cornea. Even warm compresses can provide relief. In more serious cases, such as those in which vision is impaired, the nodules may need to be removed surgically with a process called keratectomy. There are different methods of keratectomy, including the increasingly popular phototherapeutic keratectomy (PTK), for which a laser is used to remove the nodules.

Prevalence

• Salzmann’s nodular degeneration is considered rare. According to the Clinical and Experimental Optometry report of Salzmann’s disease, the condition arises more frequently in women than in men. Some studies suggest a higher frequency in middle-aged women. Most research indicates that the disease is bilateral (occurring in both eyes) in 80 percent of patients, but conflicting research indicates the condition is usually unilateral. Essentially, the disease can go either way.