Pterygium

Pterygium
SYMPTOMS Irritation | May affect vision if advanced | Often asymptomatic
SIGNS Injection | Wing-like fibrovascular tissue extending from the conjunctiva to the cornea - usually at the 3-9 o’clock position | Iron line (Stocker line)
WORK-UP Thorough history. Slit lamp examination
TREATMENT
Observation | UV-blocking sunglasses | Preservative-free artificial tears for comfort | Surgical excision may be indicated if vision is affected or excessive astigmatism is induced.
Topical steroids may be indicated if inflamed or symptomatic: Pred Forte 1% 1 gtt OU qid | Lotemax 1 gtt OU qid
FOLLOW-UP Annual eye exams, every 1-2 weeks during topical steroid treatment
ADDITIONAL LAB | TESTS None
ETIOLOGY UV exposure
DIFFERENTIAL DX CIN | Pinguecula | Limbal dermoid | Pannus | Limbal stem cell deficiency
NOTES After surgery, recurrence is not uncommon