Dry Eye Mimicry
This video snippet showing a patient with Salzmann’s nodular degeneration in the cornea. Often patients with these corneal nodules will report that they have dry eyes, but the discomfort is from the thinned epithelium over the nodule becoming inflamed with epithelial breakdown also possible. These patients can have co-existent ocular surface disease (i.e. , dry eye) which can and does exacerbate the inflammation caused by these Salzmann’s nodules. Medical treatment is similar to how we treat dry eye patients (including scleral lenses), but in some cases, surgical removal of the nodule is performed.
One last nugget… there is a similar condition that is called Peripheral hypertrophic subepithelial corneal degeneration (PHSCD). It is likely that Salzmann’s nodules and PHSCD are in continuum of the pathology. See the Nature article on PHSCD for additional details: Schargus, M., Kusserow, C., Schlötzer-Schrehardt, U. et al. Peripheral hypertrophic subepithelial corneal degeneration presenting with bilateral nasal and temporal corneal changes. Eye 29, 88–97 (2015). https://doi.org/10.1038/eye.2014.236.