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Dr. Sharada Hubli
Assistant professor,
Major S D University,
Farrukhabad
 (Pterygion = a wing) is a wing-shaped fold of
conjunctiva encroaching upon the cornea from
either side within the interpalpebral fissure
 Etiology.
 Etiology of pterygium is not definitely known.
 But the disease is more common in people living
in hot climates.
 Therefore, the most accepted view is that it is a
response to prolonged effect of environmental
factors such as exposure to sun (ultraviolet rays),
dry heat, high wind and of dust
 It may be unilateral or bilateral.
 It presents as a triangular fold of conjunctiva
encroaching the cornea in the area of palpebral
aperture, usually on the nasal side ,but may also occur
on the temporal side.
 Deposition of iron seen sometimes in corneal
epithelium anterior to advancing head of pterygium is
called stocker's line
A fully developed pterygium consists of three
parts
i. Head (apical part present on the cornea),
ii. Neck (limbal part), and
iii. Body (scleral part) extending between limbus and
the canthus
 Depending upon the progression
1. Progressive
2. Regressive pterygium.
Progressive pterygium :
 Thick, fleshy and vascular with a few infiltrates in the
cornea, in front of the head of the pterygium (called
cap of pterygium).
Regressive pterygium :
 Thin, atrophic, attenuated with very little vascularity.
 There is no cap.
 Ultimately it becomes membranous but never
disappears
 Symptoms.
 Pterygium is an asymptomatic condition in the
early stages, except for cosmetic intolerance.
 Visual disturbances occur when it encroaches the
pupillary area .
 Occasionally diplopia may occur due to limitation
of ocular movements.
 Complications
 cystic degeneration and infection are infrequent.
 Rarely, Neoplastic change -malignant melanoma,
may occur.
 Pseudopterygium.
 Pseudopterygium is a fold of bulbar conjunctiva
attached to the cornea.
 Causes:
 chemosed bulbar conjunctiva.
 Occurs following chemical burns of the eye
Pterygium Pseudopterygium
Degenerative process Inflammatory process
Usually occurs in elderly Can occur at any in age
Always situated in the palpebral
aperture
Can occur at any site
Either progressive, regressive, or
stationary
Always stationary
Probe cannot be passed underneath A probe can be passed under the
neck
 Surgical excision is the only satisfactory treatment,
 Indicated for:
(1) cosmetic reasons,
(2) continued progression threatening to encroach
onto the pupillary area (once the pterygium has
encroached pupillary area, wait till it crosses on the
other side),
(3) diplopia due to interference in ocular movements.
 Recurrence of the pterygium after surgical excision
is the main problem (30-50%)
 After topical anesthesia, exposed using universal
eye speculum.
 Head of the pterygium is lifted and dissected off
the cornea very meticulously
 The main mass of pterygium is then separated
from the sclera underneath and the conjunctiva
superficially.
 Pterygium tissue is then excised taking care not to
damage the underlying medial rectus muscle
 Homeostasis is achieved and the Episcleral tissue
exposed is cauterized thoroughly.
 The conjunctiva is sutured back to cover the sclera.
PTERYGIUM ,clinical picture and its management.pptx
PTERYGIUM ,clinical picture and its management.pptx

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PTERYGIUM ,clinical picture and its management.pptx

  • 1. Dr. Sharada Hubli Assistant professor, Major S D University, Farrukhabad
  • 2.  (Pterygion = a wing) is a wing-shaped fold of conjunctiva encroaching upon the cornea from either side within the interpalpebral fissure  Etiology.  Etiology of pterygium is not definitely known.  But the disease is more common in people living in hot climates.  Therefore, the most accepted view is that it is a response to prolonged effect of environmental factors such as exposure to sun (ultraviolet rays), dry heat, high wind and of dust
  • 3.
  • 4.
  • 5.  It may be unilateral or bilateral.  It presents as a triangular fold of conjunctiva encroaching the cornea in the area of palpebral aperture, usually on the nasal side ,but may also occur on the temporal side.  Deposition of iron seen sometimes in corneal epithelium anterior to advancing head of pterygium is called stocker's line
  • 6. A fully developed pterygium consists of three parts i. Head (apical part present on the cornea), ii. Neck (limbal part), and iii. Body (scleral part) extending between limbus and the canthus
  • 7.  Depending upon the progression 1. Progressive 2. Regressive pterygium. Progressive pterygium :  Thick, fleshy and vascular with a few infiltrates in the cornea, in front of the head of the pterygium (called cap of pterygium). Regressive pterygium :  Thin, atrophic, attenuated with very little vascularity.  There is no cap.  Ultimately it becomes membranous but never disappears
  • 8.  Symptoms.  Pterygium is an asymptomatic condition in the early stages, except for cosmetic intolerance.  Visual disturbances occur when it encroaches the pupillary area .  Occasionally diplopia may occur due to limitation of ocular movements.  Complications  cystic degeneration and infection are infrequent.  Rarely, Neoplastic change -malignant melanoma, may occur.
  • 9.  Pseudopterygium.  Pseudopterygium is a fold of bulbar conjunctiva attached to the cornea.  Causes:  chemosed bulbar conjunctiva.  Occurs following chemical burns of the eye
  • 10. Pterygium Pseudopterygium Degenerative process Inflammatory process Usually occurs in elderly Can occur at any in age Always situated in the palpebral aperture Can occur at any site Either progressive, regressive, or stationary Always stationary Probe cannot be passed underneath A probe can be passed under the neck
  • 11.  Surgical excision is the only satisfactory treatment,  Indicated for: (1) cosmetic reasons, (2) continued progression threatening to encroach onto the pupillary area (once the pterygium has encroached pupillary area, wait till it crosses on the other side), (3) diplopia due to interference in ocular movements.  Recurrence of the pterygium after surgical excision is the main problem (30-50%)
  • 12.  After topical anesthesia, exposed using universal eye speculum.  Head of the pterygium is lifted and dissected off the cornea very meticulously  The main mass of pterygium is then separated from the sclera underneath and the conjunctiva superficially.  Pterygium tissue is then excised taking care not to damage the underlying medial rectus muscle  Homeostasis is achieved and the Episcleral tissue exposed is cauterized thoroughly.  The conjunctiva is sutured back to cover the sclera.