The primary cause of 68 enucleations in the University Hospital, Kuala Lumpur, are reviewed and compared with those from Uganda and Jerusalem. Trauma 25% especially in the 20 - 29 age group was the most important cause, followed by corneal diseases 22% seen largely over the age of 50. Malignant tumours 16% consisting nearly all of retinoblastoma and a very low incidence of malignant melanoma when compared with the Caucasians. Glaucoma 12% was mainly of the narrow angle type. Males predominate nearly all age groups with an overall ratio of 2:1 and a peak of 5:1 in trauma.
Eleven corneal specimens from nine patients with Salzmann's nodular degeneration of the cornea, together with all available clinical information, were collected for this study. The specimens were examined by light and electron microscopy. An antecedent keratitis was diagnosed by history and microscopic findings in every case. The corneal epithelium showed degenerative changes, its thickness varied, and in nodular areas it often consisted of only a single layer of flattened epithelial cells by light microscopy. Bowman's membrane was missing over the nodules, and in this zone there was excessive secretion of a basement membrane-like material. Hyaline degeneration of collagen, cellular debris, and electron-dense hyaline deposits were seen in the collagen of the nodules. The number of fibrocytes in the nodules varied from many that were active to a few that were degenerating. External irritation because of poor epithelial protection was interpreted as a causative factor, although other tissue repair mechanisms may also have played a role.