pterygium case presentation

1. OPHTHAL
SHORT CASE11/18/2013 1ophthal short case

2. Short case
Only prelimineries and chief complaint
are required.
Examination of one eye is only
needed.
Only Positive findings are to be noted.
11/18/2013 2ophthal short case

3. • 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 3ophthal short case

4. Provisional diagnosis:- pterygium of
right eye with immature cataract.11/18/2013 4ophthal short case

5. Differential diagnosis
• Pseudo pterygium.
• Pinguecula
• Limbal dermoid
• Phlectenacular conjunctivitis
• Scc
• Malignant melanoma
• Episcleritis
11/18/2013 5ophthal short case

6. Comparision
pterygium
1. Degenerative process
2. Common in elderly
persons.
3. Always situated in the
palpebral aperture.
4. Progressive regressive or
stationery
5. Probe test negative
Pseudo pterygium
1. Inflamatory process.
2. Can occur at any age
3. Can occur at any site
4. Always stationery
5. Probe test positive
11/18/2013 6ophthal short case

7. 11/18/2013 7ophthal short case

8. Common degenerative condition of conjunctiva
characterised by yellowish patch on bulbar
conjunctiva near limbus.
11/18/2013 8ophthal short case

9. 11/18/2013 ophthal short case 9

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12. 11/18/2013 ophthal short case 12

13. THE PTERYGIUM

14. DISCUSSION
1. ETIOLOGY
2. PATHOLOGY
3. CLINICAL FEATURES
4. COMPLICATIONS
5. DIFFERENTIAL DIAGNOSIS
6. TREATMENT
11/18/2013 14ophthal short case

15. • 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 15ophthal short case

16. 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
11/18/2013 16ophthal short case
Encroach ment of pupillary area in
progressive stage
Astigmatism due to fibrosis in regressive
stage

17. • Diplopia due to restriction of movements.
• Signs:-
• Triangular fold of conjunctiva encroaching
cornea mostly on nasal side
• Parts—head, neck , body , cap
11/18/2013 ophthal short case 17

18. • Types:-progressive, regressive
11/18/2013 ophthal short case 18

19. 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.
11/18/2013 ophthal short case 19

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