pterygium

ophthal short case 1

OPHTHAL SHORT CASE11/18/2013

2

Short caseOnly prelimineries and chief complaint

are required.Examination of one eye is only

needed.Only Positive findings are to be noted.

11/18/2013 ophthal short case


• NAME:-Y.Baalayogi• AGE :-45yrs• SEX:- Male• COMPLAINT:-Growth in the right eye since 3

months ,not affecting the vision.No other complaints.

• EXAMINATION :-Right eye • Fold of conjunctiva from nasal side covering the

limbus but not extending over the pupillary area.• Lens is greyish white in colour.Iris shadow present.• Peripheral opacification of cornea is seen.• All other structures are normal.

11/18/2013


Provisional diagnosis:- pterygium of right eye with immature cataract.

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Differential diagnosis

• Pseudo pterygium.• Pinguecula• Limbal dermoid • Phlectenacular conjunctivitis• Scc• Malignant melanoma• Episcleritis

11/18/2013


Comparision pterygium1. Degenerative process2. Common in elderly

persons.3. Always situated in the

palpebral aperture.4. Progressive regressive or

stationery5. Probe test negative

Pseudo pterygium1. Inflamatory process.2. Can occur at any age

3. Can occur at any site

4. Always stationery

5. Probe test positive

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ophthal short case 711/18/2013


Common degenerative condition of conjunctiva characterised by yellowish patch on bulbar

conjunctiva near limbus.

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THE PTERYGIUM

14

DISCUSSION

1. ETIOLOGY2. PATHOLOGY3. CLINICAL FEATURES4. COMPLICATIONS5. DIFFERENTIAL DIAGNOSIS6. TREATMENT

11/18/2013 ophthal short case


• Etiology:-• Not definitely known• Common in tropics• Exposure to heat uv light and dust.• Pathology:-• Degenerative and hyperplastic condition• Elastoic degeneration of sub conjunctival

tissue• Proliferates as vascularised granulatoin tissue

under epithelium and encroaches cornea• Outer 3 layers of cornea are destroyed.11/18/2013


Clinical features• Demographic:-• common in old age males doing outdoor work.• Unilateral or bilateral mostly on nasal side

• Symptoms:-• Cosmetic intolerance in asymtomatic stage.• Foreign body sensation• Defective vision

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Encroach ment of pupillary area in progressive stage

Astigmatism due to fibrosis in regressive stage


• Diplopia due to restriction of movements.• Signs:-• Triangular fold of conjunctiva encroaching

cornea mostly on nasal side• Parts—head, neck , body , cap

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• Types:-progressive, regressive

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Treatment

• Surgical removal is the only satisfactory treatment

• Recurrence rate is up to30-50%.to avoid it • CLAU,CMMC,excision with lamellar

keratectomy and lamellar keratoplasty.

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Healthcare

pterygium