Pterygium

Wing shaped fold of bulbar conjunctiva encroaching upon cornea from either side within interpalebral fissure

Hot climates
Prolonged exposure to Sun (UV) , dry heat , High wind, Abundance of dust

Pathology

Elastotic degeneration
Proliferation of vascularised granulation tissue under epithelium of conjunctiva

Which encroaches cornea

Old age
Males with outdoor activities
Usually on Nasal side

Symptoms

Asymptometic in early stages
Cosmetic intolerance

Foreign body sensation

Defective vision due to corneal Astigmatism
Diplopia due to limited ocular movement

Sign

Part of fully developed Pterygium

Head : Apical part on Cornea
Neck : Constricted part in limbal area
Body : Scleral part between limbus & canthus
Cap : Semilunar Whitish infilterate in front of head

Types

Progressive

Thick , Fleshy,Vascular

Fuch’s spots / islets of Vogt also called Cap of Pterygium

Regressive

Thin,atrophic, little vascular

No Cap
Deposition of iron (Stocker’s line ) anterior to head of Pterygium

Complications

Cystic degeneration
infection
Neoplasia

Treatment

Surgical excision
Indicated for :
Cosmetic disfigurement
visual impairment
Continued progression
Diplopia

Steps:

  1. Topical anaesthesia
  2. Universal Eye speculum
    3,Dissection of head
    4.Separation of main mass
  3. Excision of Pterygium tissue
  4. Hemistasis is achieved
    7.CONJUNCTIVAL LIMBAL AUTOGRAFT (CLAU) (Most effectve method)

Recurrence ( more common)

Measures

Surgical excision with free Conjunctival limbal autograft

SE with Amniotic membrane graft & Mitomycin C (MMC) when very large Pterygium

SE with Lamellar keratectomy & Keratoplasty