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Pterygium

Essentials

  • A pterygium is a benign change in which the conjunctiva grows slowly and in a triangular shape over the limbus onto the cornea.
  • A pterygium is treated surgically if it causes harm or threatens the patient's vision.
  • UV radiation is a significant aetiological factor in the development of a pterygium.

Symptoms and signs

  • A pterygium develops when the normal function of the limbus located at the border between the conjunctiva and cornea is disturbed. This allows the growth of a triangular wedge of vascular conjunctiva on the surface of the cornea (picture F1). The growth is promoted by a hot, dry, and dusty environment as well as UV radiation. It may cease spontaneously.
  • The lesion is situated in the lid space, usually on the nasal side of the eye.
  • A pterygium is often asymptomatic and discovered as an incidental finding.
  • A pterygium grows over months and years towards the central cornea and eventually may permanently decrease the patient's visual acuity and narrow the visual field.
  • In some patients the pterygium becomes irritated, causing daily inconvenience and tear-flow. It may be associated with significant irregular astigmatism that may disappear after surgical treatment.

Treatment

  • Moisturizing eye drops can help with irritation symptoms.
  • As necessary, anti-inflammatory medication, such as topical glucocorticoids, in courses for inflammatory symptoms
  • Surgery is the treatment of choice if the pterygium causes problems or affects visual acuity.
  • A permanent scar is can be left on the cornea after surgical resection of the pterygium.
  • A pterygium often recurs after resection Prevention of Recurrence of Pterygium after Surgery.

    References

    • Hacioglu D, Erdöl H. Developments and current approaches in the treatment of pterygium. Int Ophthalmol 2017;37(4):1073-1081. [PubMed]
    • Akbari M. Update on overview of pterygium and its surgical management. J Popul Ther Clin Pharmacol 2022;29(4):e30-e45. [PubMed]
    • Bradley JC, Yang W, Bradley RH, et al. The science of pterygia. Br J Ophthalmol 2010;94(7):815-20. [PubMed]

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