A pterygium is a wedge-shaped growth of the conjunctiva that spreads from the white of the eye onto the cornea, most often on the nasal side. It is linked to long-term sun, wind and dust exposure, so it is common in people who work outdoors.
Key symptoms
- Visible fleshy growth on the white of the eye
- Redness and irritation
- Gritty, foreign body feeling
- Dry, burning eyes
- Blurred vision if it reaches the center of the cornea
What you find on exam
- Triangular, raised tissue with blood vessels extending onto the cornea
- Usually on the nasal side, may affect both eyes
- Visual acuity
- Slit lamp: size and distance from the pupil
- Signs suspicious for tumor: unusual color, rapid growth, large feeder vessels
Tests
- Clinical diagnosis with the slit lamp
- Visual acuity and refraction to detect astigmatism
- Corneal topography if vision is affected
- Biopsy if it looks atypical
Treatment basics
- UV-blocking sunglasses and hats
- Artificial tears for dryness and irritation
- Short course of a mild topical steroid for inflamed flares
- Surgical excision with a conjunctival autograft if vision is threatened or symptoms are severe
- Follow-up for regrowth
Red flags
- Growth reaching the visual axis or reducing vision
- Rapid growth, pigmentation or irregular shape
- Severe pain, discharge or sudden vision loss
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Sources: NCCPA PANCE Content Blueprint; NBOME COMLEX-USA clinical presentations; AAMC Core Entrustable Professional Activities (Core EPAs). Written by Making Synapses. Making Synapses is not affiliated with these organizations.