MDT EYE Ptreygium

Question 1

______is a degeneration of fibrovascular, deep conjunctival layers resulting in vascular tissue proliferation, which extends onto the cornea

• have features seen in malignant tissues and can be associated with premalignant lesions
• Related to sunlight exposure, chronic inflammation and oxidative stress

Answer 1

pterygium

Question 2

What would you suspect?
Symptoms:
Irritation, redness, decreased vision; may be asymptomatic

Signs: Wing-shaped fold of fibrovascular tissue arising from the interpalpebral conjunctiva and extending onto the cornea. Usually nasal in location.

Answer 2

Pterygium

Question 3

What are some ddx for pterygium?

Answer 3

(1) Pinguecula (yellow-white, flat or slightly raised conjunctival lesion)- does not progress onto cornea
(2) Conjunctival intraepithelial neoplasia

Question 4

Labs/Studies/EKG for Pterygium

Answer 4

Slit lamp examination to identify the lesion

Question 5

TX for pterygium

Answer 5

(1) Protect eyes from sun, dust, and wind (UV-blocking sunglasses or goggles).
(2) Lubrication with artificial tears four to eight times per day (for irritation).

Question 6

Tx For an inflamed pterygium: Mild

Answer 6

Artificial tears QID

Question 7

TX For an inflamed pterygium: Moderate to severe

Answer 7

Ophthalmic Corticosteroids
NSAID drop
Ketorolac (Acular) 0.5% solution, use 1 drop in affected eye QID

Question 8

Surgical removal for Ptreygium is indicated ONLY when:

Answer 8

(a) The pterygium threatens the visual axis or induces significant astigmatism.
(b) The patient is experiencing excessive irritation not relieved by the
aforementioned treatment.
(c) The lesion is interfering with contact lens wear.
(d) Consider removal prior to cataract or refractive surgery.

Question 9

Initial Care of the Disease and Follow Up:

(1) Asymptomatic patients may be checked every ___ years.
(2) Pterygia should be measured periodically (every 3 to 12 months, initially) to determine…………
(3) If treating with a topical steroid, check after a few weeks to monitor _______ and _____.

Answer 9

1. 1 to 2
2. the rate at which they are growing toward the visual axis
3. inflammation and IOP