Spheroid degeneration of the cornea and conjunctiva. 1. Clinical course and characteristics

The clinical picture of spheroid degeneration of the cornea and conjunctiva clearly fits into three characteristic patterns: (1) a primary corneal type associated with increasing age, (2) a secondary corneal type associated with significant preexisting ocular pathology, and (3) a conjunctival form which may or may not be associated with either type of corneal degeneration. The primary corneal form is usually bilateral, located only in the peripheral cornea, superficial stroma in depth, found as single spherules or in clusters, and seen in otherwise normal eyes primarily in older patients with median age of 69 years. The secondary corneal type is usually unilateral, involves central or peripheral cornea, may be superficial or deep, may take forms other than single or groups of spherules, is found only in eyes with corneal pathology, and may be found in adults of any age. The conjunctival form may be found alone or with either type of corneal degeneration and is frequently associated with pingueculae. The clinical course in most cases is stationary and asymptomatic. However, the secondary corneal form may progress and have associated symptomatology. Possible factors important in the etiology of this degeneration include age, sex, associated ocular pathology, glaucoma, and environment. Spheroid degeneration of the cornea or conjunctiva fluoresces brightly under ultraviolet illumination.