Salzmanns Nodules Symptoms, Causes, Surgery, Recovery

The development of nodules is most frequently caused by unknown factors, but they have also been linked to inflammation, trauma, and surgical procedures. The average age at which Salzmann nodular degeneration occurs is in the fifth decade of life, while it can happen at any age between 4 and 90. Bilateral instances predominate. It primarily affects women, and White people are more likely to be affected by it than other races. 

In conditions like Salzmann's nodular degeneration, the surface of a normal cornea gets cloudy in odd places. These result in blurred vision, photophobia, and occasionally, pain from foreign bodies. Although spontaneous remission is improbable, topical anti-inflammatory medication and lubrication usually help symptoms.

Salzmanns Nodules Symptoms

Salzmann's nodular degeneration manifests clinically as superficial, bluish-white, elevated lesions that are frequently found in the periphery of the cornea. In more severe situations, patients may also have impaired vision in addition to irritants like dryness and a foreign body sensation.

Mild peripheral instances are frequently asymptomatic. In advanced cases, eyesight is impaired or distorted, and numerous or shadowy images appear. Pain and foreign body sensation occur infrequently.

Salzmanns Nodules Causes

Pathogenesis of SND is not fully understood, but it is thought to be caused by poor protection of the epithelium and disruption of the interface between the epithelium and the stroma. This allows epithelial-derived growth elements to get into the stroma and activate stromal fibroblasts, which leads to the deposition of disorganized extracellular membrane components under the epithelium. SND most typically affects Caucasian females in their fifth, eighth, and ninth decades.

Salzmanns Nodules Surgery

It is possible to successfully remove Salzmanns nodules using either a blade or an excimer laser (a procedure known as phototherapeutic keratectomy, or PTK). After excision, the nodules can sometimes come back. Recurrences may be less frequent if the anti-scarring drug mitomycin-C is used during the operation.

Local removal of the epithelium or epithelial debridement, with or with no use of alcohol, can be done in cases of nodules that are hard to see. Forceps are used to grab the nodule's edge and drag it toward the limbus or periphery. It is possible to construct a surgical plane by first peeling out a portion of the nodule's edge. Manual separation or rough dissection is usually sufficient in this case.

If the nodule is stuck to the limbus, which is usually caused by a fibrovascular pannus, the nodule may be cut off close to the limbus with scissors. After the nodule is taken out, the stroma underneath is usually smooth and even.

Salzmanns Nodules Recovery

A superficial keratectomy is used to treat the Salzmanns nodule by removing the nodule. In a superficial keratectomy, the epithelium, or the top "skin" layer of the cornea, is removed. To avoid recurrence, contributory eye problems must be treated continuously after healing from the procedure. These remedies are intended to reduce eye discomfort that occurs over an extended period, such as dry eye, meibomian gland dysfunction, and blepharitis. Within twelve years of surgery, the reappearance incidence of Salzmanns Nodules following Phototherapeutic Keratectomy is thought to be around 20%. Fortunately, patients with SND rarely need corneal and lamellar transplants.