Edit concept Question Editor Create issue ticket

Salzmann's Nodular Dystrophy

Dystrophy Salzmann's Nodular Corneal


Presentation

  • It is our ambition to present a complete survey of all medical phenomena named for a person, with a biography of that person. Disclaimer: Whonamedit? does not give medical advice.[whonamedit.com]
  • Carlson Today’s patient presentation has Fuchs’ Corneal Dystrophy, a visually significant nuclear sclerotic cataract, an elevated Salzmann’s Nodule , and only has one eye.[alancarlsonmd.com]
  • 62-year-old woman presents with 3 years of progressive decrease in vision September 9, 2013 Chief Complaint A 62-year-old woman presents with a 3-year history of painless, progressive loss of vision in both eyes.[webeye.ophth.uiowa.edu]
  • Case presentation: A 61-year-old patient presented with a history of cataract in both eyes, reducing vision to 20/60 OD and 20/50 OS. The exam revealed white discrete nodules on the anterior corneal surface causing negative fluorescein staining.[healio.com]
  • The Specifics of SND SND is a rare, non-inflammatory, slowly progressive, degenerative condition. 2 Women are significantly more likely to experience SND than men. 3,4 The average age of presentation is 59 years, and the most common symptom associated[reviewofoptometry.com]
Fever
  • It has usually developed in corneas with a history of phlyctenulosis, trachoma, vernal keratoconjunctivitis, measles, scarlet fever, and various other viral diseases.[ncbi.nlm.nih.gov]
  • Etiology: Salzmann's nodular degeneration has been associated with trachoma, interstitial keratitis, vernal keratoconjunctivitis, phlyctenular keratoconjunctivitis, ocular trauma, measles, scarlet fever, and previous surgery.[missionforvisionusa.org]
  • SND has been shown to co-occur in patients with a history of ocular surface disease, including phlyctenulosis, vernal keratoconjunctivitis, interstitial keratitis, trachoma, scarlet fever, measles, and other viral diseases [4] .[eyewiki.aao.org]
Hypertension
  • Hypertensive Retinopathy Iris and Ciliary Body Lacrimal System Lens Lids Neuro-Ophthalmology Optic Nerve Orbit Retina Sclera Strabismus, Ocular Motility Disorders Systemic Diseases Vitreous Z Videos Z-iPodcasts Z_Op-Videos Endorsed by iPod Podcasting[atlasophthalmology.net]
  • Past Ocular History Myopia, presbyopia, astigmatism Dry eye syndrome, with relief of symptoms with artificial tears No ocular surgeries Medical History Hypertension Medications No ocular medications.[webeye.ophth.uiowa.edu]
  • Traditional therapy includes: Topical anti-hypertensives to reduce ocular pressure and corneal edema and prevent further damage to the corneal endothelium Topical hyperosmotics to reduce corneal edema Bandage contact lenses to decrease pain of ruptured[odpcli.com]
Progressive Loss of Vision
  • 62-year-old woman presents with 3 years of progressive decrease in vision September 9, 2013 Chief Complaint A 62-year-old woman presents with a 3-year history of painless, progressive loss of vision in both eyes.[webeye.ophth.uiowa.edu]
Eye Pain
  • Many contact lens complications such as “tight lens syndrome,” contact lens-related red eye, and a poor fitting contact lens may all mimic the beginning stages of a corneal ulcer, so it is always best to have the cornea evaluated if any eye pain or blurred[ncascade.com]
  • Lacrimation or watering of eyes. Pain. Epithelial defects. Photophobia (increased sensitivity to light). Visible plaque in the eye. Redness (less common).[aimu.us]
Neglect
  • In rare cases of neglected nodules within the visual axis, anterior stromal haze may compromise the final visual results.[webeye.ophth.uiowa.edu]
Headache
  • I'm at a loss here...my left eye vision is now 20/80 and my right eye is 20/30 causing bad headaches every day. I am a bookkeeper by trade and its now starting to interfere with my work.[optometryforums.com]

Workup

  • Clinical examination: A general medical workup is advisable in patients with systemic association of the disease. Examination of eyes should be carried out under slit lamp (bio-microscopy) by an eye specialist.[aimu.us]

Treatment

  • In these eyes recurrences seem to occur more frequently after treatment. Of 35 eyes documented to have Salzmann's nodular degeneration during the last 15 years in our department, 22 needed PTK treatment.[ncbi.nlm.nih.gov]
  • Ideal for ophthalmic practitioners and allied health professionals alike, this indispensable resource is your comprehensive guide for the speedy diagnosis and treatment of the most common eye disorders.[books.google.com]
  • Figure 2: Topography before treatment.[webeye.ophth.uiowa.edu]
  • Treatment: Medical therapy consists of lubrication, warm compresses, lid hygiene, topical steroids, and/or oral doxycycline and has been successful in over half of the patients in some series.[missionforvisionusa.org]
  • How Much Does a Superficial Keratectomy Treatment Cost in Nashville? The cost of your superficial keratectomy treatment may be covered by your vision and medical insurance.[bestvisionforlife.com]

Prognosis

  • This reduces the healing time and improves visual prognosis post-operatively. DSEKs can be used as treatment for conditions such as Fuch’s Endothelial Dystrophy.[lincolneyelaser.com]
  • Salzmann’s nodular corneal degeneration (SNCD): Clinical findings, risk factors, prognosis and the role of previous contact lens wear. Cont Lens Anterior Eye. 2011 Aug;34(4):173-8. 4. Fario AA, Halperin GI, Sved N, et al.[reviewofoptometry.com]
  • Salzmann's nodular corneal degeneration (SNCD): Clinical findings, risk factors, prognosis and the role of previous contact lens wear. Contact Lens and Anterior Eye. 2011;34(4):173-178.[webeye.ophth.uiowa.edu]
  • Salzmann’s Nodular Corneal Degeneration: Clinical Findings, Risk Factors, Prognosis and the Role of Previous Contact Lens Wear.[eyewiki.aao.org]

Etiology

  • Therefore, although the etiology remains uncertain, it is thought that SND can be triggered by multiple events that lead to a non-specific corneal tissue reaction based on individual predisposition.[remedicajournals.com]
  • Etiology: Salzmann's nodular degeneration has been associated with trachoma, interstitial keratitis, vernal keratoconjunctivitis, phlyctenular keratoconjunctivitis, ocular trauma, measles, scarlet fever, and previous surgery.[missionforvisionusa.org]
  • Whereas subtle recurrences are common in most cases over a 5 to 15 year period, visually significant recurrences are uncommon (5 to 20%) and can be minimized with meticulous control of the etiology responsible for the condition [1, 2].[webeye.ophth.uiowa.edu]
  • DEPENDING UPON ETIOLOGY A] Age related degeneration:- Arcus senilis, Vogt’s white limbal girdle, Hassal-Henle bodies,Mosaic degeneration.[slideshare.net]
  • Etiology There has not been a specific causal etiology described to date.[eyewiki.aao.org]

Epidemiology

  • In terms of epidemiology, a wide age range in both men and women has been reported.[remedicajournals.com]
  • - metabolism Disease Progression Corneal Dystrophies, Hereditary - epidemiology Aged Gelsolin - genetics Mutation Finland - epidemiology Amyloidosis - metabolism Journal Article Details Digital rights Loading Rights Save Investigative ophthalmology &[query.library.utoronto.ca]
  • Table 2 Epidemiology Onset often around 50 years of age, but has been reported in ages 13-92 [2] Female patients account for 75-90% of all cases [1,2]. Often bilateral [1,2].[webeye.ophth.uiowa.edu]
  • Epidemiology 72%-88% of cases occur in females [10] . SND is more common in Caucasian women in the 6th decade of life but can be seen in both males and females of all ages beginning near adolescence [3] [7] .[eyewiki.aao.org]
Sex distribution
Age distribution

Pathophysiology

  • 1p34.3,13pTel-13q12.13, 18q21.2–q21.32, 20p13-p12, 10p11.2 COL8A, SLC4A11, TCF8, TCF4 posterior polymorphous corneal dystrophy AD 20p11.2, 1p34.3-p32.3, 10p11.2 COL8A2, TCF8, OVOL2, GRHL2 Congenital hereditary endothelial dystrophy AR 20p13-p12 SLC4A11 Pathophysiology[en.wikipedia.org]
  • Pathophysiology One hypothesis suggests that enzymatic destruction of Bowman’s layer results in migration and proliferation of keratocytes from the posterior stroma, resulting in secondary deposition of extracellular matrix components in nodular areas[eyewiki.aao.org]

Prevention

  • Avoidable - 0% Emergent - ED Care Needed - Not Preventable/Avoidable - 0% Primary diagnosis of injury 0% Primary diagnosis of mental health problems 0% Primary diagnosis of substance abuse 0% Primary diagnosis of Alcohol 0% Unclassified 100% We Could[medicbind.com]
  • Some have also advocated the concomitant use of mitomycin-C after surgery aimed at preventing an SND recurrence (Bowers et al, 2003).[clspectrum.com]
  • Ongoing treatment/prevention is aimed at controlling chronic irritation of the eye such as dry eye , blepharitis and meibomian gland dysfunction.[moyeseye.com]
  • I'll keep the patient on his medication long-term to keep the refraction stable and prevent the nodules from returning.[reviewofophthalmology.com]

Ask Question

5000 Characters left Format the text using: # Heading, **bold**, _italic_. HTML code is not allowed.
By publishing this question you agree to the TOS and Privacy policy.
• Use a precise title for your question.
• Ask a specific question and provide age, sex, symptoms, type and duration of treatment.
• Respect your own and other people's privacy, never post full names or contact information.
• Inappropriate questions will be deleted.
• In urgent cases contact a physician, visit a hospital or call an emergency service!