An easy presentation for pterygium case along with history taking points.

1. Pterygium
Name : Dikshita Das
Roll No: 11171027

2. • Latin : Pterygion = A Wing
• It is a wing shaped fold of conjunctiva , invading the
cornea from either side within the inter-palpebral
fissure.
• It is a degenerative and hyper-plastic condition of
conjunctiva.
Definition

4. Risk Factors
• They are not definitely known .
• It is common in people living in hot climates and in
those who work outdoors.
• Therefore , the most accepted view is that it is the
response to prolonged exposure to sunlight
(ultraviolet rays) , dry heat , high wind and abundance
to dust .
• Mostly seen in old age .

5. Symptoms:
• Foreign Body Sensation along with discomfort and
irritation
• Defective Vision
• Diplopia
• Cosmetic intolerance

6. • Triangular Fold of Conjunctiva
encroaching the cornea in the
area of the palpebral aperture
.
Signs

7. Parts of Pterygium

8. Signs
• Stocker Line ( deposition of iron) seen anterior to the
advancing head of pterygium on the corneal
epithelium

9. Types
• Progressive Pterygium:
A. Thick , fleshy , Vascular
B. Whitish infiltrates in the cornea known as Fuch’s
spots or islets of Vogt ( cap of pterygium )
• Regressive Pterygium:
A. Thin , atrophic , attenuated with little vascularity
B. Deposition of Stocker’s Line
C. It becomes membranous but never disappears

10. Pterygium Pseudopterygium
Etiology Degenerative process Inflammatory process
Age
Usually occurs in old
age
Can occur at any age
Site
Always situated in the
palpebral aperture
Can occur at any site
Stages
Either progressive ,
regressive or
stationary
Always stationary
Probe Test
Probe cannot be
passed underneath
Probe can be passed
under the neck
Pterygium must be differentiated from
pseudopterygium

11. Treatment
Medical Treatment :
• Tear Substitutes
• Topical Steroids
• Protection from UV rays
Surgical Treatment :
• Surgical Excision with free conjunctival limbal autograft (
CLAU)
• Surgical Excision with amniotic membrane graft and
mitomycin-c (0.02%) (MMC)
• Surgical Excision with lamellar keratectomy and
keratoplasty
Old Methods-
1. McRaynold’s operation
2. Postoperative use of beta irradiations

12. Surgical Technique of Pterygium excision
a)Dissection of head from the cornea
b) Excision of pterygium tissue under
the conjunctiva
c) Conjunctival limbal autograft after
excising the pterygium

13. Case Presentation for a Pterygium Case
Name : XXXXX
Age : Usually occurs past middle age
Sex: Occurs in males > females (2:1)
Occupation : Outdoor work (mostly)
Chief Complaints: c/o irritation and foreign body sensation in the eye for the past 3
months
History: i) H/o defective vision
ii) H/o diplopia
iii) prolonged exposure to sunny , hot , dusty atmosphere
Ocular Examination : i) a wing shaped fold of conjunctiva encroaching upon the
cornea in the area of the palpebral aperture is seen on the nasal side.
ii) It is over 4mm in size and is thick and vascularised.
iii) Presence of cap in front of the head indicates that it is a
progressive pterygium.

14. Differential Diagnosis : Pterygium should be differentiated from
pseudopterygium
Line of Management :
i) Medical - Tear Substitutes , Topical Steroids
ii) Surgical - surgical excision using CLAU , MMC , lamellar
keratectomy and keratoplasty.