Highlights & Basics
- A pterygium is a wing-shaped fibrovascular overgrowth from the conjunctiva onto the corneal surface. Occurs in the interpalpebral region, usually from the nasal side, and is often bilateral.
- Typically there is a history of excessive chronic ultraviolet (UV) light exposure. Often found in people who spend a lot of time outdoors, or people living within 40° latitude of the equator.
- Symptoms include impaired ocular cosmesis, ocular irritation, and reduced vision.
- All patients should use ocular UV protection such as wraparound sunglasses and wide-brimmed hats. If symptomatic, topical lubricants may help.
- Surgical intervention is indicated if significant ocular irritation persists despite medical therapy; or if there is impaired ocular cosmesis, reduced visual acuity, continued progression, or double vision.
Quick Reference
History & Exam
Key Factors
Other Factors
Diagnostics Tests
Treatment Options
Definition
Epidemiology
Etiology
Pathophysiology
Images
Citations
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The College of Optometrists. Pterygium. Jun 2024 [internet publication].[Full Text]
Clearfield E, Muthappan V, Wang X, et al. Conjunctival autograft for pterygium. Cochrane Database Syst Rev. 2016;(2):CD011349.[Abstract][Full Text]
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11. Coroneo MT. Pterygium as an early indicator of ultraviolet insolation: a hypothesis. Br J Ophthalmol. 1993 Nov;77(11):734-9.[Abstract][Full Text]
12. Dushku N, Reid TW. Immunohistochemical evidence that human pterygia originate from an invasion of vimentin-expressing altered limbal epithelial basal cells. Curr Eye Res. 1994 Jul;13(7):473-81.[Abstract]
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15. The College of Optometrists. Pterygium. Jun 2024 [internet publication].[Full Text]
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20. Allan BD, Short P, Crawford GJ, et al. Pterygium excision with conjunctival autografting: an effective and safe technique. Br J Ophthalmol. 1993;77:698-701.[Abstract][Full Text]
21. Al Fayez MF. Limbal versus conjunctival autograft transplantation for advanced and recurrent pterygium. Ophthalmology. 2002 Sep;109(9):1752-5.[Abstract]
22. Zheng K, Cai J, Jhanji V, et al. Comparison of pterygium recurrence rates after limbal conjunctival autograft transplantation and other techniques: meta-analysis. Cornea. 2012 Dec;31(12):1422-7.[Abstract]
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25. Shi YJ, Yan ZG, Yue HY, et al. Meta-analysis of fibrin glue for attaching conjunctival autografts in pterygium surgery. Zhonghua Yan Ke Za Zhi. 2011 Jun;47(6):550-4.[Abstract]
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27. Ma DH, See LC, Liau SB, et al. Amniotic membrane graft for primary pterygium: comparison with conjunctival autograft and topical mitomycin C treatment. Br J Ophthalmol. 2000 Sep;84(9):973-8.[Abstract]
28. Luanratanakorn P, Ratanapakorn T, Suwan-Apichon O, et al. Randomised controlled study of conjunctival autograft versus amniotic membrane graft in pterygium excision. Br J Ophthalmol. 2006 Dec;90(12):1476-80.[Abstract][Full Text]
29. Li M, Zhu M, Yu Y, et al. Comparison of conjunctival autograft transplantation and amniotic membrane transplantation for pterygium: a meta-analysis. Graefes Arch Clin Exp Ophthalmol. 2012 Mar;250(3):375-81.[Abstract]
30. Ozer A, Yildirim N, Erol N, et al. Long-term results of bare sclera, limbal-conjunctival autograft and amniotic membrane graft techniques in primary pterygium excisions. Ophthalmologica. 2009;223(4):269-73.[Abstract]
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32. Asregadoo ER. Surgery, thio-tepa, and corticosteroid in the treatment of pterygium. Am J Ophthalmol. 1972 Nov;74(5):960-3.[Abstract]
33. Singh G, Wilson MR, Foster CS. Long-term follow-up study of mitomycin eye drops as adjunctive treatment of pterygia and its comparison with conjunctival autograft transplantation. Cornea. 1990 Oct;9(4):331-4.[Abstract]
34. Frucht-Pery J, Siganos CS, Ilsar M. Intraoperative application of topical mitomycin C for pterygium surgery. Ophthalmology. 1996 Apr;103(4):674-7.[Abstract]
35. Dadeya S, Kamlesh. Intraoperative daunorubicin to prevent the recurrence of pterygium after excision. Cornea. 2001 Mar;20(2):172-4.[Abstract]
36. Bahrassa F, Datta R. Postoperative beta radiation treatment of pterygium. Int J Radiat Oncol Biol Phys. 1983 May;9(5):679-84.[Abstract]
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38. Bekibele CO, Ashaye A, Olusanya B, et al. 5-Fluorouracil versus mitomycin C as adjuncts to conjunctival autograft in preventing pterygium recurrence. Int Ophthalmol. 2012;32:3-8.[Abstract]
39. Lee BWH, Sidhu AS, Francis IC, et al. 5-Fluorouracil in primary, impending recurrent and recurrent pterygium: systematic review of the efficacy and safety of a surgical adjuvant and intralesional antimetabolite. Ocul Surf. 2022 Oct;26:128-41.[Abstract]
40. Rubinfeld RS, Pfister RR, Stein RM, et al. Serious complications of topical mitomycin-C after pterygium surgery. Ophthalmology. 1992 Nov;99(11):1647-54.[Abstract][Full Text]
41. Moriarty AP, Crawford GJ, McAllister IL, et al. Severe corneoscleral infection. A complication of beta irradiation scleral necrosis following pterygium excision. Arch Ophthalmol. 1993 Jul;111(7):947-51.[Abstract]
42. Kheirkhah A, Izadi A, Kiarudi MY, et al. Effects of mitomycin C on corneal endothelial cell counts in pterygium surgery: role of application location. Am J Ophthalmol. 2011 Mar;151(3):488-93.[Abstract]
43. Young AL, Ho M, Jhanji V, et al. Ten-year results of a randomized controlled trial comparing 0.02% mitomycin C and limbal conjunctival autograft in pterygium surgery. Ophthalmology. 2013 Dec;120(12):2390-5.[Abstract]
44. Fallah MR, Khosravi K, Hashemian MN, et al. Efficacy of topical bevacizumab for inhibiting growth of impending recurrent pterygium. Curr Eye Res. 2010;35:17-22.[Abstract]
45. Hu Q, Qiao Y, Nie X, et al. Bevacizumab in the treatment of pterygium: a meta-analysis. Cornea. 2014 Feb;33(2):154-60.[Abstract]
46. Fonseca EC, Rocha EM, Arruda GV. Comparison among adjuvant treatments for primary pterygium: a network meta-analysis. Br J Ophthalmol. 2018 Jun;102(6):748-56.[Abstract]
47. Mandalos A, Tsakpinis D, Karayannopoulou G, et al. The effect of subconjunctival ranibizumab on primary pterygium: a pilot study. Cornea. 2010 Dec;29(12):1373-9.[Abstract]
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51. Clearfield E, Muthappan V, Wang X, et al. Conjunctival autograft for pterygium. Cochrane Database Syst Rev. 2016;(2):CD011349.[Abstract][Full Text]
