My friend has Salzmann's nodular degeneration. What can she expect to happen to her sight? They removed a tumor and said to come back in a year. She is in extreme pain and can hardly keep her eye open.

M.L.

Salzmann's nodular degeneration is a condition of the cornea that develops following episodes of corneal inflammation. The many possible predisposing conditions include viral conjunctivitis (pink eye), measles, scarlet fever, chlamydia eye infections and various other viral diseases. It is often found in both eyes, and seems to be more common in women.

Salzmann's nodular degeneration is characterized by elevated, blue-white bumps (nodules) on the cornea. The nodules, ranging in number from one to nine, usually appear on parts of the eye where they do not affect vision.

Generally, Salzmann's nodules are not painful, although in advanced stages, they can be associated with eye pain. Other symptoms may include sensitivity to light, eyelid twitching and tearing.

For mild cases, the treatment of Salzmann's involves artificial tears (lubricants). If the nodules are located in the field of vision, or if the symptoms of pain or tearing become more serious, a surgical procedure called a superficial keratectomy is performed to remove the nodules. In this procedure, performed with just eyedrops for anesthesia, the nodules are carefully removed with a surgical blade. This results in a smoother corneal surface, which may reduce tearing and improve vision. Salzmann's nodules can recur, although their growth is generally very slow.

As for your friend, she should certainly return to her eye surgeon and find out why the pain has become extreme. It is possible to develop a corneal infection following surgical removal of the nodules. Symptoms of an infection include eye pain, redness, and sensitivity to light. If your friend has an infection, it is vital that she see her surgeon for treatment.