Pterygium and pinguecula Flashcards
yellowish lesions at his nasal limbus in both eyes and you suspect that he has a degenerative condition of the conjunctiva.
Name the two conditions that it is most likely to be, and with the aid of diagrams, compare and contrast the features of these two conditions (6)
Pterygium and pinguecula
they both tend to have some of the same risk factors
- both tend to occur due to excessive UV exposure and are more likely to occur to in countries which are in general warmer.
- also tend to occur in similar regions to each other that they may be at the nasal or temporal side of the limbus.
- both happen due to a breakdown of collagen within the stroma of the conjunctiva.
- They both have a tendency to be bilateral.
Contrasting features are
- pinguecula only the conjunctiva is involved and its formed like a bump which is yellowish in colour
- whereas a pterygium tends to take a sort of wedge-shaped appearance and encroaches on to the cornea.
With a pinguecula vision is not affected as the degeneration only happens on the conjunctiva whereas for a pterygium vision can be affected as it encroaches on the cornea, then it can go onto the visual axis and then can induce astigmatism.
A patient who has pinguecula normally has no symptoms at all but someone with a pterygium will present with blurred vision, pain, irritation and grittiness.
explain and state management of pingeucula in laymans terms
A pinguecula is a small yellow raised area that appears on the surface of the white part of the eye.
mild condition - usually happens due to excessive exposure to sunlight or just occurring from working in some outdoor jobs.
shouldn’t cause any harm and you shouldn’t have any symptoms at all.
In terms of the management plan the patient should be advised to limit the amount of time they have exposed to UV
- can be done by wearing a hat or even wearing sunglasses if it is a warm sunny day.
if pinguecula does appear a bit inflamed then cold compresses can be applied to promote vasoconstriction.
in very rare cases the patient may ask to get it removed -
usually done by laser and this tends to happen when its for cosmetic appearances but only if it bothers the patient.
explain and state management of pterygium in laymans terms
A red ish tissue growth beginning on the white part of the eye extending to the cornea, which includes the iris and pupil, over time and may then grow big enough to cover your pupil thereby affecting vision.
- occurs in areas of warm climate meaning there is increased UV exposure due to long term exposure and those who work outdoors are likely to get it.
- condition is slightly worse than a pinguecula
- patient will present with irritation, grittiness, blurred vision as it approaches the visual axis which is the part of the eye which is responsible for clear vision.
advise px to try and limit exposure to UV by limiting time outdoors, wearing sunglasses/tinted lenses or even wearing a hat which reduces the risk of it developing.
most px don’t require anything and if it was noticed as a mistake then referral is not needed.
Artificial tears can be given for symptomatic relief if the patient has discomfort. If the lesion is beginning to approach the visual axis then referral to ophthalmologist who will consider surgical excision
