progressive peripheral pterygium

Progressive Peripheral Pterygium: A Growing Concern

A progressive peripheral pterygium, also known as a central pterygium, is a type of corneal growth that affects the surface of the eye. It is characterized by a gradual and progressive growth of conjunctival tissue onto the cornea, often resulting in a wing-like or triangular shape [10][11].

This condition typically occurs more frequently at the nasal limbus than the temporal area, with a characteristic wing-like appearance [11]. As it advances, the pterygium can grow over the iris and pupil, causing blurred vision and contact lens intolerance [7].

Symptoms of progressive peripheral pterygium may include:

• Fleshy bumps or growths on the surface of the eye
• Foreign body sensation or discomfort in the eye
• Decreased vision due to distortion of the cornea
• Astigmatism or changes in refractive power

It is essential to note that a progressive peripheral pterygium can be associated with other conditions, such as vasculitis and erythema elevatum diutinum [5][6]. If left untreated, this condition can lead to more severe complications, including vision loss.

References:

[7] As the pterygium advances, it can grow over your iris and pupil, causing blurred vision. A pterygium can also cause contact lens intolerance. [10] Pterygium typically has a triangular or wing-like shape. The word, “pterygium,” comes from the Greek words pteryx, meaning “wing,” and pterygion, meaning “fin.” [11] Pterygium, from the Greek pterygos meaning “wing”, is a common ocular surface lesion originating in the limbal conjunctiva within the palpebral fissure with progressive involvement of the cornea.

Progressive Peripheral Pterygium Signs and Symptoms

A progressive peripheral pterygium is a type of pterygium that grows progressively towards the center of the cornea, causing various signs and symptoms.

• Growth on the eye: A progressive peripheral pterygium can grow over the white part of your eye (sclera) and onto the clear tissue covering your eyeball (conjunctiva).
• Redness: The affected area may appear red due to increased blood vessel growth.
• Itching: Some people may experience itching or irritation in the affected area.
• Blurred vision: As the pterygium grows, it can cause blurred vision or distorted vision due to irregular astigmatism (a condition where the cornea is not perfectly round).
• Gritty feeling: You might feel a gritty sensation or foreign body sensation in your eye.
• Impaired ocular cosmesis: A progressive peripheral pterygium can affect the appearance of your eye, making it look abnormal.

Symptoms of Recurrence

If you've had surgery to remove a pterygium and experience symptoms again, they may include:

• Signs and symptoms usually occur 4-6 weeks after surgery.
• Redness, itching, or irritation in the affected area.
• Blurred vision or distorted vision due to irregular astigmatism.

References

• Kaufman SC, Jacobs DS, Lee WB, Deng SX, Rosenblatt MI, Shtein RM. Options and adjuvants in surgery for pterygium: a report by the American Academy of Ophthalmology. Ophthalmology. 2014;121(1):14-24.
• Sarkar P. Pterygium: A review of its clinical features and management options. Journal of Clinical and Diagnostic Research. 2023;17(5):OC01-OC05.

Note: The information provided is based on the context search results, specifically references [2], [3], [4], [5], [6], [7], [8], [9], [10], [11], [12], and [15].

Diagnostic Tests for Progressive Peripheral Pterygium

Progressive peripheral pterygium, a type of conjunctival pterygium, can be diagnosed through various tests and examinations.

• Slit-lamp examination: A slit-lamp examination is essential in diagnosing progressive peripheral pterygium. This test allows the eye doctor to closely examine the eye and observe the lesion under magnification [4].
• Corneal topography: Corneal topography can aid in determining the visual impact of the pterygium by demonstrating induced astigmatism [7].
• Visual acuity tests: Visual acuity tests, such as those that measure how sharp your distance vision is, can also be used to assess the impact of progressive peripheral pterygium on vision.
• Manifest refraction assessment: Changes in manifest refraction can also aid in determining the visual impact of the pterygium.

These diagnostic tests are crucial in assessing the severity and impact of progressive peripheral pterygium on the eye. A comprehensive examination by an eye doctor is essential to determine the best course of treatment.

References: [4] - Sep 19, 2023 — We can make a formal diagnosis following a slit-lamp examination that allows close-up observation of the lesion under magnification. [7] - Oct 15, 2024 — Diagnostic procedures​​ Assessment of visual acuity, changes in manifest refraction, and corneal topography can aid in determining the visual impact.

Based on the provided context, it appears that there are various treatment options for progressive peripheral pterygium.

Conservative Approach Early in the disease process, a conservative approach is often taken, limiting therapy to lubricating medications [1]. This may be sufficient for mild cases or those with minimal symptoms.

Medical Treatment Options Throughout the years, medical treatment for pterygium has used various agents, including:

• Bile and urine (relatively benign)
• Lead-acid, mercuric lanolin, radiotherapy, thiotepa, 5-fluorouracil (more toxic)
• Mitomycin C (recently used in combination with conjunctival grafting techniques)

Specific Treatment Options Some specific treatment options for progressive peripheral pterygium include:

• Over-the-counter anti-allergy drops and lubricating eye drops to alleviate symptoms [3]
• Artificial tears and weak topical steroids to reduce inflammation in children with small pterygia [8]
• Mitomycin C treatment combined with conjunctival grafting techniques, which significantly reduces recurrence compared to other treatments [5]

Adjunctive Treatment After surgery, adjunctive treatment may include conventional immunosuppressants as well as antiviral drugs [12][14]. The efficacy and safety of anti-vascular endothelial growth factor agents and cyclosporine have been postulated but require further studies [15].

It's essential to note that the best treatment approach will depend on individual factors, such as the severity of symptoms and the stage of the disease. A healthcare professional should be consulted for personalized advice.

References: [1] Context 1 [3] Context 3 [5] Context 5 [8] Context 8 [12] Context 12 [14] Context 14 [15] Context 15

Differential Diagnosis of Progressive Peripheral Pterygium

Progressive peripheral pterygium, also known as true pterygium, is a degenerative process that can be challenging to diagnose due to its similarity with other ocular surface lesions. The differential diagnosis for progressive peripheral pterygium includes:

• Pseudopterygium: A non-progressive condition that can mimic the appearance of a true pterygium [5].
• Pinguecula: A yellow-white mound or aggregation of smaller mounds on the bulbar conjunctiva adjacent to the limbus, which can precede the development of pterygium [3].
• Phlyctenulosis: An inflammatory condition that can cause small, nodular lesions on the conjunctiva and cornea [2].
• Peripheral microbial keratitis: A bacterial infection that can cause inflammation and damage to the peripheral cornea [2].
• Ocular surface squamous neoplasia (OSSN): A type of cancer that can affect the conjunctiva and cornea [8, 15].

To differentiate these conditions from progressive peripheral pterygium, ophthalmologists should consider the following factors:

• Progression: True pterygium is a progressive condition, whereas pseudopterygium is non-progressive [5].
• Histology: The histological appearance of true pterygium is characterized by fibrovascular proliferation and degenerative changes in the collagen [10].
• Location: Pterygium typically occurs on the nasal side of the eye, while pinguecula can occur on either side [13].

Accurate diagnosis of progressive peripheral pterygium requires a thorough understanding of these differential diagnoses and careful consideration of the patient's clinical presentation.

References:

[2] - Context 2 [3] - Context 3 [5] - Context 5 [8] - Context 8 [10] - Context 10 [13] - Context 13 [15] - Context 15