PURPOSE: To revisit the clinical presentations of Salzmann's nodular corneal degeneration (SNCD) and to identify risk factors, occurrence and prognosis, and in particular to assess the role of previous contact lens wear as an aetiological factor. METHODS: Retrospective case note review of all cases of Salzmann's nodular degeneration over the last twenty years. We analysed epidemiological features, characteristics of lesions, risk factors and final outcomes. RESULTS: Thirty eyes (19 patients) were identified with SCND. Eleven patients had bilateral disease. Our cohort included 14 female (73.7%) and 5 males (26.3%). Average age at presentation was 58.9 (range 30-75) years. Follow up range was 0-13 years. The most common presenting symptom was foreign body sensation (68.4%). Ocular pathologies were: dry eyes (56%), chronic blepharitis (32%), trichiasis (8%), trachoma (32%), previous ocular trauma (8%), and previous ocular surgery (21.4%). Sixteen percent of cases were soft monthly disposable contact lens wearers. None of our patients with rigid contact lens wear developed Salzmann's nodules. Surgical excision was needed in 4 cases (13.3%). Two of them developed recurrent disease. CONCLUSION: Salzmann's nodular corneal degeneration is a disorder affecting middle-aged white women predominantly, and seems to be associated with concomitant chronic MGD, dry ocular surface, soft contact lens wear and previous ocular surgery. The prognosis is very good, and most patients are "successfully" treated with medical management alone, and therefore correct diagnosis of the disease is paramount. If indicated, various surgical options are available and give good outcomes. However, Salzmann's nodules can recur after penetrating keratoplasty.
PURPOSE: To revisit the clinical presentations of Salzmann's nodular corneal degeneration (SNCD) and to identify risk factors, occurrence and prognosis, and in particular to assess the role of previous contact lens wear as an aetiological factor. METHODS: Retrospective case note review of all cases of Salzmann's nodular degeneration over the last twenty years. We analysed epidemiological features, characteristics of lesions, risk factors and final outcomes. RESULTS: Thirty eyes (19 patients) were identified with SCND. Eleven patients had bilateral disease. Our cohort included 14 female (73.7%) and 5 males (26.3%). Average age at presentation was 58.9 (range 30-75) years. Follow up range was 0-13 years. The most common presenting symptom was foreign body sensation (68.4%). Ocular pathologies were: dry eyes (56%), chronic blepharitis (32%), trichiasis (8%), trachoma (32%), previous ocular trauma (8%), and previous ocular surgery (21.4%). Sixteen percent of cases were soft monthly disposable contact lens wearers. None of our patients with rigid contact lens wear developed Salzmann's nodules. Surgical excision was needed in 4 cases (13.3%). Two of them developed recurrent disease. CONCLUSION:Salzmann's nodular corneal degeneration is a disorder affecting middle-aged white women predominantly, and seems to be associated with concomitant chronic MGD, dry ocular surface, soft contact lens wear and previous ocular surgery. The prognosis is very good, and most patients are "successfully" treated with medical management alone, and therefore correct diagnosis of the disease is paramount. If indicated, various surgical options are available and give good outcomes. However, Salzmann's nodules can recur after penetrating keratoplasty.