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SYMPTOMS
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Symptoms vary depending on complication: Recurrence - blurry vision, irritation | Corneal scar - possible blurry vision | Scleral melt - pain
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SIGNS
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Signs vary depending on complication: Recurrence - typical signs of a pterygium (wing-like fibrovascular tissue, etc.) | Corneal scar - scarring due to tissue remodeling from pterygium removal | Scleral melt - thin, necrotic scleral tissue
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WORK-UP
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Thorough history. Slit lamp examination
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TREATMENT
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Pterygium recurrence and corneal scarring can be observed unless vision is threatened | Scleral melt must be treated aggressively: Topical antibiotics | Oral steroids and/or other immunosuppressive agents | Autograft with antimetabolite (MMC or possibly 5-FU)
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FOLLOW-UP
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Pterygium recurrence and corneal scarring are not urgent | Scleral melt must be monitored very closely (daily until demonstrated improvement)
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ETIOLOGY
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Pterygium surgery | Antimetabolite use
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NOTES
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Mitomycin-C and 5-fluorouracil should be used with caution as they may increase the risk of corneal and/or scleral necrosis | Most recurrences following pterygium surgery occur within the first year
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