In this series of posts, I will try to share the health-related topics illustrated with pictures. Our today’s topic is Pterygium. And this is my first post to the GEMS community.
Why choose “Pterygium” as of today’s topic?
Yesterday morning one Bangladeshi patient came to my chamber with his sponsor. Although I am a general physician sometimes patients suffering for eyes, ears problems also come to me. One of the reasons may be the unavailability of those specialists in and around my working place. Anyway, his complaint was some foreign body sensation in his left eye for the last month. When he looked at the mirror he saw something on the black central portion of his left eye. The similar feature was absent in his right eye. When I saw his left eye, I also saw reddish-whitish stuff across the conjunctiva and corneal junction and extended from conjunctiva to cornea. The reddish-whitish stuff was pterygium. So, I wanted to share a post on pterygium with the hiver users.
What is a pterygium?
A pterygium is nothing but excessive growth of (tissue of) conjunctive (white part of an eye) towards the corner (the black centre of an eye). It is a visible lesion of an eye where anyone can easily notice it. It may occur unilaterally or bilaterally. At the initial stage, it may not be apparent enough to be noticed by an individual. However, when it starts crossing the junctions between the conjunctiva and the cornea, patients usually become aware of it. It is commonly seen in people of age between 30 to 50 years.
Pterygiums approaching from both the inner and outer angles of an eye. It is also known as kissing pterygium source of the image
Why does a pterygium develop?
Anyone can have a pterygium in one or both of his/her eyes. However, some factors may contribute to developing this condition. Living in a hot climate, more ultraviolet exposure, sun exposure, dust exposure and dryness of eyes etc. are found in association with an increased incidence of pterygium.
What are the features of a pterygium?
Firstly, it can be completely asymptomatic. However, it may create problems in the cosmetic aspect.
Secondly, a person may feel some foreign body sensation, irritation or grittiness in the affected eye.
Thirdly, if a person wears a contact lens, a developing pterygium may lift the edge of the lens causing irritation by the lens.
Fourthly, if a pterygium advances more over the cornea, it may obscure the visual axis, hence resulting in visual abnormalities. It also can induce astigmatism.
It also mark cornea, conjunctiva and iris image source
The severity of a pterygium:
Depending upon the presence of conjunctival tissue on the cornea, a pterygium can be divided into three types (image below):
Type 1: If a pterygium extends only less than 2mm on the cornea.
Type 2: When it is less than 4 mm.
Type 3: If it encroaches more than 4 mm and affects the visual axis.
image is made by compiling images from the textbook mentioned below
What are the management options for a pterygium?
An artificial eye drop or tear substitution may help in reducing the dryness, hence irritation.
Wearing sunglasses may protect an eye from the UV lights which have a stimulating effect on the growth of a pterygium.
Steroid eye drop may minimize the inflammation. In my practical experience, it also reduces the size of pterygium in some instances.
Surgery is the last and most effective option to remove a pterygium. There are various methods of surgery. An ophthalmologist can decide which one is the best one for a patient. Unfortunately, there are chances of recurrence following surgery.
This is all about today's education with the pictures.
Are you having this condition in your eyes? Look at the mirror now and find out if there is any pterygium.
Is any of your family member suffering from it? Check their eyes today :)
Hope that this post will be beneficial for the readers. If you have any questions or suggestions, please let me know in the comment section.
References:
- Ophthalmic diagnosis and treatment, edition 3rd; page 106
- Kanski and Bowling clinical ophthalmology - A systematic approach edition 7th; page: 219,220
Keep wearing a mask and stay safe from the pandemic (In Sha Allah)
Until Next Time
Dr Hafiz
