Pterygium: Difference between revisions
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When associated with the conjunctiva, a pterygium commonly grows from the [[nose|nasal]] side of the [[sclera]]. It is associated with, and thought to be caused by [[ultraviolet]]-light exposure (e.g. [[sunlight]]), low humidity, and dust. The predominance of pterygia on the nasal side is possibly a result of the sun's rays passing laterally through the cornea where it undergoes refraction and becomes focused on the limbic area. Sunlight passes unobstructed from the lateral side of the eye, focusing on the medial limbus after passing through the cornea. On the contralateral side, however, the shadow of the nose medially reduces the intensity of sunlight focused on the [[Human anatomical terms#Anatomical directions|lateral]]/[[temporal]] limbus.<ref name=Coroneo>{{cite journal|last=Coroneo|first=MT|date=November 1993|title=Pterygium as an early indicator of ultraviolet insolation: a hypothesis|journal=Br J Ophthalmol|volume=77|issue=11|pages=734-9|pmid=8280691|url=http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pubmed&pubmedid=8280691}}</ref> | When associated with the conjunctiva, a pterygium commonly grows from the [[nose|nasal]] side of the [[sclera]]. It is associated with, and thought to be caused by [[ultraviolet]]-light exposure (e.g. [[sunlight]]), low humidity, and dust. The predominance of pterygia on the nasal side is possibly a result of the sun's rays passing laterally through the cornea where it undergoes refraction and becomes focused on the limbic area. Sunlight passes unobstructed from the lateral side of the eye, focusing on the medial limbus after passing through the cornea. On the contralateral side, however, the shadow of the nose medially reduces the intensity of sunlight focused on the [[Human anatomical terms#Anatomical directions|lateral]]/[[temporal]] limbus.<ref name=Coroneo>{{cite journal|last=Coroneo|first=MT|date=November 1993|title=Pterygium as an early indicator of ultraviolet insolation: a hypothesis|journal=Br J Ophthalmol|volume=77|issue=11|pages=734-9|pmid=8280691|url=http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pubmed&pubmedid=8280691}}</ref> | ||
== | ==Historical Perspective== | ||
==Classification== | |||
==Pathophysiology== | |||
Pterygium in the conjunctiva is characterized by elastotic degeneration of [[collagen]] and fibrovascular proliferation. | Pterygium in the conjunctiva is characterized by elastotic degeneration of [[collagen]] and fibrovascular proliferation. | ||
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Occasionally it is found as an [[incidental finding]] in middle aged patients who spend a lot of time in the sun. Pterygiums are also among younger men and women who surf, wakeboard, and kiteboard due to excessive exposure to UV rays bouncing off of the water. Skiiers and snowboarders protect their eyes on the snow so athletes participating in water sports also need to take heed of the UV rays and protect their eyes. | Occasionally it is found as an [[incidental finding]] in middle aged patients who spend a lot of time in the sun. Pterygiums are also among younger men and women who surf, wakeboard, and kiteboard due to excessive exposure to UV rays bouncing off of the water. Skiiers and snowboarders protect their eyes on the snow so athletes participating in water sports also need to take heed of the UV rays and protect their eyes. | ||
==Causes== | |||
==Differentiating Pterygium From Other Diseases== | |||
==Epidemiology and Demographics== | |||
===Age=== | |||
===Gender=== | |||
===Race=== | |||
==Risk Factors== | |||
==Screening== | |||
==Natural History, Complications, and Prognosis== | |||
==Diagnosis== | |||
===Diagnostic Study of Choice=== | |||
===History and Symptoms=== | |||
===Physical Examination=== | |||
===Laboratory Findings=== | |||
===Electrocardiogram=== | |||
===X-ray=== | |||
===Echocardiography or Ultrasound=== | |||
===CT scan=== | |||
===MRI=== | |||
===Other Imaging Findings=== | |||
===Other Diagnostic Studies=== | |||
==Treatment== | ==Treatment== | ||
While patients can be symptomatically treated with artificial tears, no reliable medical treatment exists to reduce or even prevent pterygium progression. Definitive treatment is achieved only by surgical removal. Long term follow up is required as pterygium may recur even after complete surgical correction. | ===Medical Therapy=== | ||
While patients can be symptomatically treated with artificial tears, no reliable medical treatment exists to reduce or even prevent pterygium progression. ===Surgery=== | |||
Definitive treatment is achieved only by surgical removal. Long term follow up is required as pterygium may recur even after complete surgical correction. | |||
===Primary Prevention=== | |||
*There are no established measures for the primary prevention of pterygium. | |||
===Secondary Prevention=== | |||
==See also== | ==See also== | ||
*[[List of eye diseases and disorders]] | *[[List of eye diseases and disorders]] | ||
Revision as of 22:32, 19 August 2019
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Roukoz A. Karam, M.D.[2]
Synonyms and keywords: pterygia
Overview
Pterygium usually refers to a benign growth of the conjunctiva. Alternately, it refers to any winglike triangular membrane occurring in the neck, eyelids, knees, elbows, ankles or digits (J Pediatr Orthop B 2004, 13:197-201). An example is popliteal pterygium syndrome, which affects the legs. The term comes from the Greek word pterygion meaning "wing".
When associated with the conjunctiva, a pterygium commonly grows from the nasal side of the sclera. It is associated with, and thought to be caused by ultraviolet-light exposure (e.g. sunlight), low humidity, and dust. The predominance of pterygia on the nasal side is possibly a result of the sun's rays passing laterally through the cornea where it undergoes refraction and becomes focused on the limbic area. Sunlight passes unobstructed from the lateral side of the eye, focusing on the medial limbus after passing through the cornea. On the contralateral side, however, the shadow of the nose medially reduces the intensity of sunlight focused on the lateral/temporal limbus.[1]
Historical Perspective
Classification
Pathophysiology
Pterygium in the conjunctiva is characterized by elastotic degeneration of collagen and fibrovascular proliferation. It has an advancing portion called the head of the pterygium, which is connected to the main body of the pterygium by the neck. Sometimes a line of iron deposition can be seen adjacent to the head of the pterygium called Stocker's line. The location of the line can give an indication of the pattern of growth. As it is a benign growth, it requires no treatment unless it grows to such an extent that it covers the pupil, obstructing vision. Some patients may also choose surgery if the growth becomes too unsightly. The exact cause is unknown, but it is associated with excessive exposure to wind, sun, or sand. Wearing protective sunglasses with side shields and/or wide brimmed hats and using artificial tears throughout the day may help prevent their formation or stop further growth. For surfers and other water-sport athletes, they should wear eye protection that block 100% of the UV rays from the water.
Occasionally it is found as an incidental finding in middle aged patients who spend a lot of time in the sun. Pterygiums are also among younger men and women who surf, wakeboard, and kiteboard due to excessive exposure to UV rays bouncing off of the water. Skiiers and snowboarders protect their eyes on the snow so athletes participating in water sports also need to take heed of the UV rays and protect their eyes.
Causes
Differentiating Pterygium From Other Diseases
Epidemiology and Demographics
Age
Gender
Race
Risk Factors
Screening
Natural History, Complications, and Prognosis
Diagnosis
Diagnostic Study of Choice
History and Symptoms
Physical Examination
Laboratory Findings
Electrocardiogram
X-ray
Echocardiography or Ultrasound
CT scan
MRI
Other Imaging Findings
Other Diagnostic Studies
Treatment
Medical Therapy
While patients can be symptomatically treated with artificial tears, no reliable medical treatment exists to reduce or even prevent pterygium progression. ===Surgery=== Definitive treatment is achieved only by surgical removal. Long term follow up is required as pterygium may recur even after complete surgical correction.
Primary Prevention
- There are no established measures for the primary prevention of pterygium.
Secondary Prevention
See also
External links
- Facts About the Cornea and Corneal Disease The National Eye Institute (NEI)
References
- ↑ Coroneo, MT (November 1993). "Pterygium as an early indicator of ultraviolet insolation: a hypothesis". Br J Ophthalmol. 77 (11): 734–9. PMID 8280691.