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A fibrovascular growth of the conjunctiva, which encroaches onto the cornea, usually located nasally.
A benign yellow/white thickening in the interpalpebral nasal or temporal bulbar conjunctiva. Rarely requires treatment.
Although a genetic predisposition is likely, adverse atmospheric factors such as UV light, dust and wind are associated with increased incidence.
This varies with age, sex of patient (male > female), UV light exposure occupation, environment and location. There is a higher prevalence in places of lower latitude and in high UV exposure countries, eg Australia.
This should be directed to prophylaxis with the wearing of a brimmed hat and sunglasses with 100% UV light absorption.
Indications for Surgery:
- A threat to vision:
- The pterygium may impinge on the visual axis.
- Astigmatism: there is flattening of the cornea in the longitudinal axis of the pterygium.
- Persistent irritation and redness.
- Contact lenses: Pterygia must be excised in order to wear soft contact lenses successfully.
At the MetWest Eye Centre a specialist anaesthetist administers IV sedation and induces ocular anaesthesia with a peribulbar injection. This procedure is painless.
After removing the pterygium with its underlying subconjunctival fibrovascular tissue, a conjunctival autograft (from the superior bulbar conjunctiva) is placed over the conjunctival defect and secured by sutures. This graft acts as a physical barrier to regrowth.
The eye is padded for 48 hours, then antibiotic and steroid drops are instilled for three weeks. Discomfort is well controlled by simple analgesics such as paracetamol.
Recurrence with the above technique is <5% but of the order of 50% if conjunctival grafting is not performed. Infection, haemorrhage and granulomatous formation are rare.