A wing-shaped fibrovascular overgrowth from the conjunctiva onto the corneal surface. Occurs in the interpalpebral region, usually from nasal side, and is often bilateral.
Consists of a cap (sub-epithelial arc-shaped corneal opacity at the leading edge), head (white fibrous mass attached to cornea), and body (fleshy, triangular-shaped fibrovascular tissue continuous with the conjunctiva at its base).
Typically, there is a history of excessive chronic UV light exposure. Often found in people with outdoor occupations, surfers, sailors, or people living within 40° latitude of the equator.
Symptoms include impaired ocular cosmesis, ocular irritation, and reduced vision.
All patients should use ocular UV protection such as wrap-around sunglasses and wide-brimmed hats. If symptomatic, topical lubricants may help.
Surgical intervention is indicated if significant ocular irritation persists despite medical therapy; or if there is impaired ocular cosmesis, reduced visual acuity, continued progression, or double vision.
Surgical removal is generally successful, but some symptoms may persist and pterygium can recur.
eA pterygium (from the Greek pterygion, meaning wing) is a triangular-shaped fibrovascular overgrowth onto the corneal surface, continuous at its base with the conjunctiva. It occurs in the interpalpebral region usually from the nasal side and is usually bilateral. Symptoms include impaired ocular cosmesis, ocular irritation (caused by tear film disturbances over the pterygium and localised inflammation), and reduced vision (due to irregular astigmatism and occasional progressive growth of the pterygium to the visual axis/centre of cornea).
History and exam
David O'Brart, MBBS, DO, MD, FRCS, FRCOphth
Consultant Ophthalmic Surgeon
Guy's and St. Thomas' NHS Foundation Trust
Professor of Corneal Science
University of London
DOB receives research grants from Alcon Inc, and has acted as a consultant on the preparation of a report on epithelium-on-corneal collagen cross-linking for Sooft Italia SPA. He is an author of a number of references cited in this monograph.
Carlos E. Diaz, MD
Department of Ophthalmology
University of Texas Health Science Center
CED is a speaker for Bio-Tissue, the developer of Amniograft amniotic membrane.
Robert E. MacLaren, DPhil, DipEd, FRCOphth, FRCS
Professor of Ophthalmology
Nuffield Laboratory of Ophthalmology
University Of Oxford
John Radcliffe Hospital
REM declares that he has no competing interests.
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