Pterygium - symptoms, diagnosis and treatment

Pterigionul reprezintă o creștere anormală a țesutului conjunctival care acoperă partea albe a ochiului. Cauzele pterigionului sunt variate, inclusiv expunerea prelungită la soare, praf sau vânt, precum și predispoziția genetică. Tratamentul pentru pterigion poate implica utilizarea de picături oftalmice pentru ameliorarea simptomelor și reducerea inflamației. În cazurile mai severe, operația pterigionului poate fi necesară pentru îndepărtarea creșterii și prevenirea recurenței.

1. Etiology

Pterygium is an elastoid degeneration of the deep conjunctival layers resulting in proliferation of fibrovascular tissue. The causes of this condition are UV exposure and chronic inflammation. People who work in strong sun, toxic environments, sweats, residents of tropical and subtropical areas are most exposed.

2. Definition and location

Pterygium is conjunctival degeneration with progressive corneal involvement and is a common lesion of the ocular surface.

It is located at the palpebral commissure, more commonly nasal than temporal, although in some cases both locations are found (double pterygium).

It has a wing-like appearance, hence the name (gr. pteryx = wing).

3. Symptom

Ocular Irritation
Redness
Decreased vision

May be asymptomatic in the early stage.

4. Diagnosis

Pterygium is twice as common in men as in women. As for age, the incidence increases in people over 40, but most cases appear to occur between 20 and 40.

It almost always appears located near the corneal limbus around 3 or 9 o'clock.

The pterygium is a translucent membrane and consists of a head (through which it invades the cornea), a neck adherent to the cornea, and a triangular-shaped body with a fan-shaped base on the nasal/temporal conjunctiva.

Diagnosis can be made by biomicroscopic examination to identify the lesion and assess the integrity and thickness of the adjacent cornea.

If there is corneal astigmatism secondary to pterygium, corneal topography investigation is recommended.

5. Differential diagnosis

It is done with the following pathologies:

Pinguecula
Conjunctival intraepithelial neoplasia (CIN)
Limbic dermoid
Other conjunctival tumours (papilloma, nevus, melanoma)
Pseudopterygium
Panus
Sclerokeratitis.

6. Treatment and recommendations

- Protect your eyes from the sun, dust and wind by wearing sunglasses or UV-blocking goggles.

- Use artificial tears

- For an inflamed pterygium use:

Artificial tears
Topical drops containing corticosteroids
Nonsteroidal anti-inflammatory drops or a topical antihistamine ± mast cell stabiliser to reduce the discomfort produced.

- If corneal delen is present, then apply artificial tears in gel form

- Surgical removal is indicated when:

Pterygium threatens the visual axis or induces significant astigmatism.
The patient is experiencing a chronic irritation that is not relieved by the above treatment.
The lesion interferes with wearing contact lenses.
Patients are bothered by the unsightly appearance of the eye
The patient will undergo cataract or refractive surgery to achieve the best possible visual outcome.

- The pterygium should be measured periodically (every 3 to 12 months initially) to determine the rate at which it grows towards the visual axis

- If you use drops containing corticosteroids, a check-up after a few weeks is recommended to monitor inflammation and intraocular pressure. Reduce and discontinue corticosteroid-containing drops once inflammation has subsided.

- Asymptomatic, stable patients require yearly consultation to follow the evolution.

Deși un tratament medicamentos poate fi folosit ca primă intenție, de cele mai multe ori acesta doar reduce simptomele, indicat fiind tratamentul chirurgical. Acesta are atât scop estetic cât și de limitare a unor consecințe grave. Netratată, afecțiunea poate duce la scăderea vederii, limitarea mișcărilor globilor oculari și favorizarea infecțiilor la nivelul corneei.

Descoperiți mai multe informații valoroase despre oftalmologie și sănătatea ochilor vizionând materialele realizate de experți în domeniu de pe canalul nostru de YouTube.

Trabeculectomy or Glaucoma Surgery

Myopia - one of the most common eye conditions

Oftalmologie Timisoara - Doctor oftalmolog Timisoara - Dr. Yasar Servet, Medic primar oftalmolog

Primary Ophthalmologist Dr. Yasar Servet

Dr. Servet Yașar is an expert with more than 15 specialist credentials in the field of ophthalmology, attending courses in countries such as Turkey, Cyprus, Czech Republic and the United States. With over 11 years of experience in ophthalmology, including 8 years spent in Turkey and over-specialization in Vitroretinal Surgery, Dr. Yașar has been with the team of Prof. Dr. Munteanu Ophthalmology Center since 2020. Yașar is experienced in cataract surgery, glaucoma surgery, pterygium surgery and other anterior segment surgery, as well as eyelid aesthetic surgery, botox applications, strabismus surgery and vitreoretinal surgery.

- 11th July 2022

Pterygium