Summary
Definition
History and exam
Key diagnostic factors
- wing-shaped conjunctival overgrowth onto corneal surface
- history of chronic ultraviolet light exposure
- ocular irritation, burning, and tearing
Other diagnostic factors
- altered ocular cosmesis
- blurred vision
- double vision
Risk factors
- chronic ultraviolet (UV) light exposure
- increasing age
- family history of pterygium
- chronic ocular irritants
- human papilloma and Epstein-Barr virus infection
Diagnostic tests
1st tests to order
- slit-lamp examination
- fluorescein staining
Tests to consider
- corneal topographic scanning
Treatment algorithm
asymptomatic
ocular irritation, burning, or itching: without visual impairment, rapid growth, or cosmesis concerns
visual impairment or rapid enlargement or poor cosmesis
recurrent pterygia
Contributors
Authors
David O'Brart, MBBS, DO, MD, FRCS, FRCOphth

Consultant Ophthalmic Surgeon
Guy's and St. Thomas' NHS Foundation Trust
Professor of Corneal Science
King's College
University of London
London
UK
Disclosures
DOB holds noncommercial research grants with Rayner Ltd and J&J. He is an author of a reference cited in this topic.
Peer reviewers
Christopher E. Starr, MD
Associate Professor of Ophthalmology
Director of the Cornea Fellowship and Ophthalmic Education
Weill Cornell Medicine
New York Presbyterian Hospital
New York City
NY
Disclosures
CES declares that he has no competing interests.
Robert E. MacLaren, DPhil, DipEd, FRCOphth, FRCS
Professor of Ophthalmology
Nuffield Laboratory of Ophthalmology
University Of Oxford
John Radcliffe Hospital
Oxford
UK
Disclosures
REM declares that he has no competing interests.
References
Key articles
Saw SM, Tan D. Pterygium: prevalence, demography and risk factors. Ophthalmic Epidemiol. 1999 Sep;6(3):219-28. Abstract
The College of Optometrists. Pterygium. Jun 2024 [internet publication].Full text
Clearfield E, Muthappan V, Wang X, et al. Conjunctival autograft for pterygium. Cochrane Database Syst Rev. 2016;(2):CD011349.Full text Abstract
Reference articles
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Differentials
- Pseudopterygium
- Pingueculum
- Marginal keratitis
More DifferentialsGuidelines
- Pediatric eye evaluations: Preferred Practice Pattern
- Clinical management guidelines: pterygium
More GuidelinesLog in or subscribe to access all of BMJ Best Practice
Use of this content is subject to our disclaimer