I'm pretty confident about the diagnosis, it came from a doctor at Doheny Eye Instute here in Los Angeles, he's a corneal specialist, and I had confidence in him.
If you'll bear with me, I'll give you my story, as briefly as I can. Since I've got your 'ear', LOL.
Unfortunately, I belong to a Blue Cross HMO. The whole thing started because my very astute optometrist wrote me a note that said she suspected some kind of Keratitas(sp?) she told me to give the note to my primary physician, which I did, after several months I rec'vd a referral to the ophthalmologist that is part of the HMO. He took a look, said he thought the optometrist was right, and he said it was 'very unusual' and he felt I'd qualify to see the specialist, due to the rarity. After several more months I rec'vd the referral to see Dr. Song at Doheny Eye Institute. He had some impressive equipment, anyway, he immediately diagnosed it as Saltzman's. He said there were several options, the first being steroid eye drops "Alrex". I followed up 3 months later, the nodules looked much better, they were gathering together into one and I had marked improvement, but they didn't disappear. I followed up a few more times, and while there was no more improvement, they didn't get any worse. I was expecting to go on to another option, instead Blue Cross declined the next follow-up, and sent me back to the original ophthalmologist. I liked that doctor, but he was of advanced age, and felt some of the options, like surgery were too extreme, he told me it wouldn't get better, that his goal was to make me comfortable. I didn't get a vote. He retired a few years later, and I rec'vd a letter that a new ophthalmologist was under contract, I've been seeing that one for the past year. I told him I had conflicting opinions on the course of treatment, and asked him what he thought, he literally shrugged. He said to continue the Alrex, and follow up every 3 months. They've taken lots of pictures of my eyes, but haven't told me what to expect, or what my options were, nothing. Until my last visit. I told him the glare problem was worse, I noticed a decline in my vision, and that my eyes felt more strained lately after working on the computer. He told me the nodules looked about the same, that it might be normal fluctuations. However, I did tell him it was getting to be more of a problem, so he said 'let me take a look at the surrounding tissue. Then he said well you 'have a couple of small cataracts' WHAT? !?? I said 'isn't that really bad?' 'something very elderly people get?' I'm 48, not young, bit I will need my eyes for many years to come, I'm a Teacher Librarian. He said no, everybody has them, it's like a wrinkle. But you know, I remember the other doctor saying the Alrex might possibly cause cataracts. He also said the nodules are getting closer to the pupil. Then, out of the blue, he said "We might have to consider a corneal transplant'...uh, let's just say I was shocked, since he had been pretty laid back and unconcerned in the past. I told him the Doheny Doctor had said there were options, including surgical removal, he said "oh, I can write another referral, if you'd like' well, needless to say, I very much wanted that, he wrote the referral, and I'm now waiting to see if Blue Cross will approve it. To his credit the current ophthalmologist, had prescribed Restasis to combat the dry eye associated with Salzman's, and, of course, Blue Cross declined the prescription. The last time I saw him was Friday, and he now had samples, so he gave me a month's supply, I've been using them twice a day like he said. So...there you have it, another HMO nightmare. and here I am, looking into HD Wraparounds...
