Corneal Nodules and Possible Pathologies: A Case Series

Abstract

Corneal nodular lesions are not uncommon in clinical practice. Diagnosing and managing this condition can be challenging due to its variable causes. This article highlights three cases of corneal nodular lesions. A common clinical pathway for the diagnosis and treatment of cornea nodular lesions is discussed. Two young females and an elderly man presented with a unilateral corneal nodule of variable duration, which was further demonstrated on anterior segment optical coherence tomography (AS-OCT). Several diagnoses were made after thorough history and examination which include herpetic stromal keratitis, phlyctenular keratoconjunctivitis secondary to blepharitis, and Salzmann nodular degeneration. All cases were initiated on topical antibiotics and topical steroids with additional medication or surgical procedure onboard according to their clinical condition. The corneal nodules resolved with scarring after a period of treatment. In conclusion, corneal nodular lesions can be associated with various pathologies. Thorough history, examination, and appropriate investigations are needed to reveal the underlying causes. Serial anterior segment images and AS-OCT are useful to monitor progression and treatment response. Prompt diagnosis and initiation of treatment are crucial to prevent further complications.

Ocular surface lesions in clinical grades of Bell’s phenomenon

“…Superficial corneal lesions are often associated with chronic ocular inflammatory conditions [ 31 ] and are usually present within the interpalpebral fissure area [ 31 , 32 ] . In the etiopathogenesis of superficial corneal lesions in advanced age, many conditions, such as incomplete lid closure, lack of blinking, lid anomalies, ectropion/entropion, delayed tear clearance, and sunken upper eyelids may play a role [ 33 , 34 ] .…”

“…Superficial corneal lesions are often associated with chronic ocular inflammatory conditions [31] and are usually present within the interpalpebral fissure area [31,32]. In the etiopathogenesis of superficial corneal…”

Successful treatment of corneal hypertrophic scar in Hurler syndrome

“…Nodular lesions on the cornea are a rare occurrence and can have various etiologies. 14 Corneal hypertrophic lesions, such as keloids, have been documented in several congenital syndromes and ophthalmic anomalies (e.g., Lowe's syndrome and Rubinstein‐Taybi syndrome); however, primary keloid lesions are seldom reported. 15 As far as we are aware, this is the first reported case of a patient with Hurler syndrome and corneal nodular lesion in the literature.…”

“…[10][11][12][13] Nodular lesions on the cornea are a rare occurrence and can have various etiologies. 14 Corneal hypertrophic lesions, such as keloids, have been documented in several congenital syndromes and ophthalmic anomalies (e.g., Lowe's syndrome and Rubinstein-Taybi syndrome); however, primary keloid lesions are seldom reported. 15 As far as we are aware, this is the first reported case of a patient with Hurler syndrome and corneal nodular lesion in the literature.…”

Herpes simplex keratitis: A brief clinical overview

“…HSK may predispose the eye to opportunistic infections. Vigilance must be applied when managing HSK patients with steroid-antibiotic eye drops as this is contraindicated[ 176 ]; and can result in epithelial defects and vascularization[ 177 ]. On the other hand, steroid-antiviral therapy performs better than fixed antiviral therapy[ 178 ].…”