SALZMANNS NODULAR DEGENERATION
It is a non-inflammatory, degenerative process characterised by whitish-grey or bluish-white elevated sub-epithelial nodules in the superficial corneal stroma that are usually bilateral, mid-peripheral and slowly progressive. There is usually a clear area before the limbus. It can cause blurred vision if it occurs in central part blocking the visual axis. It occurs more often in women than in men. The nodules elevate the epithelium. Peripheral lesions tend to be vascularised and may look like pseudopterygium. Usually one to nine discrete para-central lesions, often in a circular array at areas of corneal scarring or at the junction of old corneal scars and clear cornea.Each nodule is separated from other nodules by clear cornea, and iron lines may outline each nodule. The underlying stroma may be vascularised but the nodules are not vascularised.
Ocular surface disorders:
One of the hypotheses suggests that enzymatic destruction of Bowman’s membrane results in migration and proliferation of keratocytes from the stroma, resulting in secondary deposition of extracellular matrix components in nodular areas.
Argentum Nitricum – pink in color. It causes the eyes to become red and swollen, and there may be associated itching and biting sensation in the eyes. In some cases, there is a sensation of dryness and heat in the eyes.
Arsenic Album – The burning in eyes is worse during the night, particularly after midnight. Along with this, marked dryness of the eyelids is present. The eyes become red and congested along with the above symptoms.
Belladonna – redness of the eyes. There is a heated sensation in the eyes along with dryness. In some cases, there may be a sand-like sensation in the eyes. There may be itching and scratching along with sensitivity to light.
Euphrasia – prominent itching and gritty sensation in the eyes. A sensation of having dust, sand, or hair in the eyes is markedly present. Burning and acrid lachrymation (tears) is another attending feature in cases of pterygium needing Euphrasia.
Nux Moschata – extends over the cornea. A sensation of fullness may be felt in the eyes, and the eyes may feel too dry in most cases.
Sulphur - sensation of a foreign body or sand in the eyes, along with a biting sensation. There may be occasional stitching or stinging in the eyes along with lachrymation in the open air.
Ammonium Bromatum – red and sore eyes. This redness and soreness is most marked during the morning. Another attending feature is a sand-like sensation the eyes along with smarting of the eyes.
Merc Sol – burning, itching, and redness of eyes. Burning in the eyes is most marked in the open air. Profuse burning lachrymation (tears) may also be present.