PTERYGIUM

T SITI HARILZA ZUBAIDAH

 TRIANGULAR FIBROVASCULAR
SUBEPITHELIAL INGROWTH OF
DEGENERATIVE BULBAR
CONJUNCTIVA
DEVELOP IN HOT CLIMATES,
CHRONIC DRYNESS AND UV
EXPOSURE
COMPLICATION : CHRONIC

 CHRONOLOGICAL :
SMALL, GREY, CORNEAL OPACITY DEVELOPS NEAR
THE NASAL LIMBUS
CONJUNCTIVA OVERGROWS THE OPACITY AND
PROGRESSIVELY ENCROACHES ONTO THE
CORNEA IN A TRIANGULAR FASHION
A DEPOSIT OF IRON (STOCKER LINE) MAY BE SEEN
IN THE CORNEAL EPITHELIUM ANTERIOR TO THE
ADVANCING HEAD OF PTERYGIUM

TREATMENT : INDICATED COSMETIC REASONS

AND VISUAL
- SIMPLE EXCISION (HR OF RECURRENCE)
- CONJUNCTIVAL AUTOGRAFT
- AMNIOTIC MEMBRANE
- MITOMYCIN C (MINIMIZE RECURRENCE, MAY
COMPLICATED BY LATE SCLERAL NECROSIS)

 TRICHIASIS
MAY OCCUR AS A RESULT OF SCARRING OF THE
LID
MARGIN
SECONDARY
TO
CHRONIC
BLEPHARITIS, HZO AND TRACHOMA
SIGNS :
- POSTERIOR MISDIRECTION OF LASHES ARISING
FROM NORMAL SITES OF ORIGIN
- TRAUMA TO THE CORNEAL EPITHELIUM MAY
CAUSE PUNCTATE EPITHELIAL EROSIONS AND
OCULAR IRRITATION MADE WORSE ON
BLINKING
- CORNEAL ULCERATION AND PANNUS FORMATION

 TREATMENT :
- EPILATION : SIMPLE AND EFFECTIVE
USING FORCEPS
RECURRENCES 4-6 WEEKS
- ELECTROLYSIS :

USEFUL FOR A FEW ISOLATED

LASHES
FREQUENTLY MULTIPLE TREATMENTS
REQUIRED TO OBTAIN A SATISFAC
TORY RESULT
RECURRENCES : REQUIRED 40% OF
CASES SCARRING

- CRYOTHERAPY :
VERY EFFECTIVE
POTENTIAL COMPLICATIONS : SKIN
NECROSIS, DEPIGMENTATION IN
DARK SKINNED INDIVIDUALS,
DAMAGE TO MEIBOMIAN GLANDS,
SALMON NOTCHINGOF THE LID
MARGIN
- ARGON LASER ABLATION :
USEFUL FOR A FEW SCATTERED
LASHES

- SURGERY FULL-THICKNESS :
WEDGES RESECTION OR ANTERIOR
LAMELLAR EXCISION MAY BE
USEFUL FOR A LOCALIZED CROP OF
LASHES RESISTANT TO OTHER
METHODS OF TREATMENT

DACRYOADENITIS
LACRIMAL GLAND INVOLVEMENT OCCURS IN
ABOUT 25% OF PX WITH IOID (IDIOPATHIC
ORBITAL INFLAMMATORY DISEASE).
MORE COMMONLY OCCURS IN ISOLATION,
RESOLVES SPONTANEOUSLY DOESNT
REQUIRE TREATMENT.
CLINICAL FEATURES :
ACUTE DISCOMFORT IN THE REGION OF
THE LACRIMAL GLAND.

SWELLING OF THE LATERAL ASPECT OF THE

EYELID

S-SHAPED
PTOSIS
CHARACTERISTIC.

TENDERNESS OVER THE LACRIMAL GLAND

FOSSA.

INJECTION OF THE PALPEBRA PORTION ON

THE LACRIMAL GLAND AND ADJACENT
CONJUNCTIVA.

LACRIMAL SECRETION MAY BE REDUCED.

 DIFFERENTIAL DIAGNOSE :
LACRIMAL GLAND INFECTION CAUSED BY
MUMPS, MONONUCLEOSIS AND LESS COMMONLY
BACTERIA.
RUPTURED DERMOID CYST MAY CAUSED
LOCALIZED INFLAMMATION IN THE REGION ON
THE LACRIMAL GLAND.
MALIGNANT LACRIMAL GLAND TUMOUR MAY
CAUSE PAIN BUT THE ONSET IS NOT ALWAYS
USUALLY ACUTE.