Pterygium

Question 1

What is pterygium ?

Answer 1

It’s a wing shaped fold of the conjunctiva that encroaches upon the cornea from either side within the inter palpebral fissure

Question 2

Pathology of pterygium

Answer 2

Degenerative and hyperplasticity condition of the conjunctiva characterised by

Elastotic degeneration of the subconjuctival tissue
Fibrovascular proliferation of the conjunctival epithelium
Corneal tissue destruction involving epithelium , bowman’s layer and superficial stroma

Question 3

Symptoms

Answer 3

Fb sensation
Cosmetic intolerance
Blurring of vision - when pupillary margin is encroached or because of astigmatism
Diplopia - rarely due to limitation of ocular movements

Question 4

What is primary double pterygium ?

Answer 4

Pterygium found on both nasal and temporal side is primary double pterygium

Question 5

Typical presentation of pterygium

Answer 5

Wing shaped / triangular shape of conjunctiva encroaching onto the cornea in the interpalpebral area usually on the nasal side

Question 6

What is stocker line ?

Answer 6

Deposition of iron in the corneal epithelium just anterior to the advancing head of pterygium

Question 7

Parts of pterygium

Answer 7

Cap (fuch’s spots / islets of vogt)- semilunar whitish infiltrate that is found in front of the head
Head - part that lies on cornea
Neck - constricted part found in the limbal area
Body - scleral part extending from limbus to canthus

Question 8

How are pterygium divided into types ?

Answer 8

Based on extent
Based on progression

Question 9

Complications of pterygium

Answer 9

Cystic degeneration and infection
Neoplastic change to epithelioma , fibrosarcoma,malignant melanoma - rare

Question 10

Dd of pterygium

Answer 10

Pseudo pterygium - formed due to inflammatory processes

Question 11

Treatment

Answer 11

Medical. Surgical refer book