OP3.5 | Pterygium — Summary & Reflection

KEY TAKEAWAYS

Pterygium is a wing-shaped fibrovascular conjunctival growth that crosses the limbus onto the cornea (invariably nasal, occasionally temporal), caused by UV-B damage to limbal stem cells leading to conjunctival epithelial migration onto the corneal surface. Three parts: head (on cornea), neck (at limbus), body (on conjunctiva). Stocker's line = iron deposit at the leading edge of the head — pathognomonic. Can cause irregular astigmatism (pinhole does NOT improve VA) and corneal opacity when it covers the visual axis. Distinguish from pseudopterygium (post-burn adhesion — probe passes at limbus), pinguecula (does NOT cross limbus), and limbal dermoid (present from birth). Management: UV protection + lubricants for small, stationary pterygium. Surgery when approaching visual axis, progressive, or symptomatic — conjunctival autograft (<10% recurrence) is standard; bare sclera technique (50–80% recurrence) is abandoned. Mitomycin C as adjuvant reduces recurrence further but risks scleral melting with excess dose.

REFLECT

Pterygium is preventable with UV protection — and yet it remains highly prevalent in India's agricultural and outdoor-labour population, partly due to limited access to sunglasses and partly due to poor awareness. As a future doctor, you may have opportunities to counsel patients at a community health posting. Reflect: what are the three most important pieces of advice you would give a 30-year-old farmer who has a small pterygium on the nasal side of his right eye that is currently not threatening his vision? Why might those messages be difficult to implement in a farming community? Write two sentences for your portfolio.