Pterygium is a growth of triangular-shaped mass on the mucous membrane, conjunctiva of the eye. The mass grows from the nasal side of the eye and overlaps the cornea. It is a triangular fibrovascular sub epithelial ingrowth of degenerative bulbar conjunctival tissue over the cornea via limbus.
This condition usually doesn’t cause problems to the patients or need any treatment, but it can be removed if it caused blurring vision or for cosmetic appearances.
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What causes it?
The cause of pterygium is not known. Exposure to UV rays is said to be the cause of growth. It happens in people who live in warm climates and spend a lot of time in sunny outdoors environment. The people prone to things like pollen, sand, dust, and smoke are at high risk.
Smaller pterygium is usually asymptomatic.
People with large pterygium have redness, blurry vision, itching, Foreign-body sensation, and eye irritation. Sometimes it can grow bigger to cover the whole pupil.
Patients who wear contact lenses may develop symptoms of irritation at an earlier stage due to edge lift
- There is a triangular encroachment of the conjunctiva on the cornea.
- A pterygium is made up of the following parts Head, Neck, Body and Cap.
- Stocker line (Linear epithelial iron deposition) may be seen.
How is the diagnosis made?
Eye Doctors use this eye examination machine called a slit lamp. Slit-lamp helps doctors to see the presence of pterygium with the magnification seen through the slit lamp.
• Stage 1: There is a papillary response. The lesion moves towards the limbus. Also, the tissues of the conjunctiva and corneal are flat.
• Stage 2: there is a minimal elevation on the conjunctival and corneal tissues. Also, there is normal vascularity, and the lesion is seen to appear on the limbus.
• Stage 3: at this stage, there is vessel congestion with moderate vascularity. Also, the pterygium covers the space between the limbus and the pupil margin.
• Stage 4: it is a more severe form of pterygium, mostly occurring in the progressive type of pterygium. Here, the pterygium moves towards the pupil and may affect vision. However, this can cause an increase in astigmatism. Also, there is vessel congestion and dilation.
This condition at its early stage only needs lubricating and anti-inflammatory eye drops. Needs surgical removal if it encroaches the cornea which can create opacity in the cornea.
The patient should be advised to wear sunglasses to reduce ultraviolet exposure.
Surgical removal of pterygium with Conjunctival autografting t or by applying mitomycin C to the operation site. is done to minimize the recurrence of pterygium after the surgery. Sutureless pterygium surgery without stitches also performed these days.
Simple excision (‘bare sclera’ technique) is not performed these days due to higher recurrence rate,
The surgical cost of Pterygium excision with graft in Nepal starts from Rs 6,000 up to 9,000.