It's not clear what causes a pterygium to develop. But most experts believe that significant risk factors include:

• Prolonged exposure to ultraviolet light
• Dry eye
• Irritants such as dust and wind

Pterygium occurrence is much greater among people who live near the equator. But it also can develop in anyone who lives in a sunny climate. It's most often seen in young adults ages 20 to 40. It appears to be more common in men than in women.
Pterygium is often preceded by a related non cancerous condition called pinguecula (pin- WEK-yoo-la). This is a yellowish patch or bump on the conjunctiva near the cornea. The conjunctiva is the thin, moist membrane on the surface of the eye.

Ans3-Risk factors for pterygium include:

Work in occupations with excessive exposure to environmental conditions (sunlight, dust, dirt, heat, dryness, wind, smoke)

Work in occupations with excessive exposure to solvents or chemicals

Family members with pterygium.

The signs of pterygium is based on the clinical appearance of the lesion. Typical findings include

1. Fibrovascular conjunctival growth within the palpebral fissure extending onto the corneal surface
2. Triangular shape with the apex, or head, extending onto the cornea
3. Vascular straightening in the direction of the advancing head of the pterygium on the corneal surface.
4. May be a thin translucent membrane or significantly thickened with an elevated mound of gelatinous material.
5. It may affect the nasal and temporal limbus of both eyes or only a single location.
6. Raised lesion, white to pink in color depending on vascularity
7. Ranges from a fine transparent area with very mild elevation, few vessels, and minimal corneal involvement in the early stages to a thick opaque vascular growth extending to the visual axis in later stages

Pinguecula are often present in the ipsilateral or contralateral eye
A pigmented epithelial iron line (Stocker’s line) adjacent to a pterygium is evidence of chronicity.
It is unusual for pterygia to deviate from the characteristic locations of three and nine o’clock within the palpebral fissure. Pterygioid lesions in other locations should elevate suspicion for alternate diagnoses.

Symptoms
In some cases, a pterygium can grow onto the cornea (the clear, outer layer of the eye). This can distort the shape of the cornea, causing a condition called astigmatism. The result can be blurred vision.Symptoms of pterygium may include:

Burning
Gritty feeling
Itching
Sensation of a foreign body in the eye
Blurred vision.

A physical examination of the eyes and eyelids confirms the diagnosis. Special tests are usually not needed.

Today a variety of options are available for the management of pterygium, from irradiation, to conjunctival auto-grafting or amniotic membrane transplantation, along with glue and suture application. As it is a benign growth, pterygium typically does not require surgery unless it grows to such an extent that it covers the pupil, obstructing vision or presents with acute symptoms. Some of the irritating symptoms can be addressed with artificial tears. However, no reliable medical treatment exists to reduce or even prevent pterygium progression. Definitive treatment is achieved only by surgical removal. Long-term follow up is required as pterygium may recur even after complete surgical correction.

Conjunctival auto-grafting is a surgical technique that is effective and safe procedure for pterygium removal. When the pterygium is removed, the tissue that covers the sclera known as the conjunctiva is also extracted. Auto-grafting replaces the bare sclera with tissue that is surgically removed from the inside of the patients’ upper eyelid. That “self-tissue” is then transplanted to the bare sclera and is fixated using sutures, tissue adhesive, or glue adhesive.

Amniotic membrane transplantation is an effective and safe procedure for pterygium removal. Amniotic membrane transplantation offers practical alternative to conjunctival auto graft transplantation for extensive pterygium removal. Amniotic membrane transplantation is tissue that is acquired from the innermost layer of the human placenta and has been used to replace and heal damaged mucosal surfaces including successful reconstruction of the ocular surface. It has been used as a surgical material since the 1940s, and has been shown to have a strong anti-adhesive effect.

Using an amniotic graft facilitates epithelialization, and has anti-inflammatory as well as surface rejuvenation properties. Amniotic membrane transplantation can also be fixated to the sclera using sutures, or glue adhesive.

Amniotic membrane transplantation with Tisseel glue application and Mitomycin-C has shown excellent cosmetic outcomes with a surface free of redness, stitching, or patches, which makes the ocular surface suitable for vision correction surgery sooner.

Most pterygia cause no problems and do not need treatment. If a pterygium affects the cornea, results are usually good after it is removed.

Recurrence

Corneal scarring

Corneal perforation

Strabismus

Non-healing epithelial defect (esp with mitomycin C)

Scleral melt (esp with mitomycin C)

People with pterygium should be seen by an ophthalmologist each year, so that the condition can be treated before it affects vision.

Call for an appointment with your ophthalmologist if you have had a pterygium in the past and your symptoms return.

The expense depends upon the grades of treatment.