Online Photo Diagnosis

By Gregory W. DeNaeyer, OD

This corneal GP patient presented with bilateral Salzmann's nodular degeneration. The lesions consist of dense collagenous tissue in the anterior stroma and are the result of chronic keratitis. They appear gray or grayish-blue and are not vascularized, although the underling stroma may be. They are benign in nature, but may compromise visual acuity if they occur centrally or cause a secondary irregular anterior topography. They may be removed by PTK laser treatment. However, as this patient had no active keratitis and had 20/20 visual acuity with her GP lenses, she was instructed to keep her eyes lubricated with artificial tears and return yearly for monitoring.

References

• Kaufman, H. Barron, B. McDonald. The Cornea, 2nd Ed. Butterworth-Heinemann 1998.
• Catania, L. Primary Care of the Anterior Segment, 2nd Ed. Appleton & Lange 1995.

Contact Lens Spectrum, Issue: June 2009