[Salzmann's nodular degeneration. Mostly an epithelial corneal dystrophy].

So-called Salzmann's nodular degeneration has been given a misleading position in the systematics of ophthalmology. The majority of cases of Salzmann's nodular degeneration are in fact a clinical entity fulfilling the criteria of epithelial corneal dystrophy involving Bowman's layer. As with all epithelial dystrophies Salzmann's nodular degeneration recurs after surgical removal. An analysis of Salzmann's original paper discloses that the etiological postulates (severe preceding keratitis, especially phlyctenular keratitis) have never been substantiated by direct observation but only suspected by indirect histopathological circumstantial evidence. This has long lost credibility and should never have been taken for real evidence. However, degenerative types of Salzmann's nodular degeneration besides the dystrophic type still exist but the etiology and pathogenesis of these degenerative types have not yet been sufficiently described. No distinction has been made in studies of Salzmann's nodular degeneration up to now between dystrophic and degenerative types which could render such publications worthless on re-evaluation. While therapy of Salzmann's dystrophy is usually simple even after recurrence this may be different with the degenerative forms. The many questions and inconsistencies which have long been noted with "Salzmann's degeneration" as it has been misunderstood, can only be answered and solved if dystrophy and degeneration are investigated separately in future studies.