Pterygium
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- Localization. Eyes and appendages
- Erythematous lesion? Erythematous lesion, Non-erythematous lesion
- Evolution time. Chronic: more than 2 weeks
- Skin lesion. Flat: macule or spot
- Surface texture. Normal/smooth
- Edges Well defined and regular
- Color.
- Distribution of lesions. Discreet/isolated injury: 1 to 5 injuries
- Associated symptoms. Itching
- Additional information. Occupational/environmental exposure
Brief information
- Benign and frequent change consisting of fibrovascular growth of the subconjunctival tissue, in the shape of a triangle, which invades the cornea.
- It can occur alone in one eye or in both eyes.
- More common in men, between 20 and 50 years of age, particularly with greater exposure to ultraviolet radiation:
- greater work exposure abroad
- sailors or snow sports enthusiasts with higher reflected radiation
- inhabitants of regions with tropical climates
- It may gradually increase in size over the years:
- In some cases, particularly at older ages, growth may stop/stabilize.
- Usually asymptomatic, but may be associated with erythema, itching, tearing, foreign body sensation and/or decreased visual acuity (secondary astigmatism).
- Predisposing factors:
- Genetics
- Exposição crónica: radiação UV, clima quente e seco, vento ou poeira atmosférica.
Differential diagnosis
- Pseudopterygium
- Pinguecula
- Nodular Episcleritis
- Marginal Keratitis
- Phlyctenula
- Conjunctival carcinoma in situ/Bowen’s epithelioma
- Conjunctival melanoma
- Ocular surface squamous neoplasm
Treatment
The therapeutic approach depends on the size of the pterygium and associated symptoms.
- In most cases there is no need for therapy. If associated discomfort, consider:
- Artificial tears (1-2 drops, 3-4 times a day)
- Decongestants, NSAIDs and topical corticosteroids (prescribed by Ophthalmology)
- UV radiation protection can help reduce symptoms and prevent progression:
- Hat with brim
- Sunglasses with UVB protection
- Refer ophthalmology for surgical treatment if:
- Visual axis involvement
- Decreased visual acuity associated with astigmatism
- Restriction of eye movement
- Atypical appearance suggesting dysplasia
- Irritability symptoms not controllable by eye drops
- Interference with the use of contact lenses
- Cosmetic reasons
After excision, recurrence is the most common complication.