Clinical and autofluorescence findings in eyes with pinguecula and pterygium

Purpose: To assess the autofluorescence size and properties of pterygium and pinguecula by anterior segment autofluorescence (AS-AF) imaging and demonstrate the difference of autofluorescence size presented in AS-AF imaging compared to the extend size of the conjunctival lesion measured by anterior segment slit-lamp photography (AS-SLE). Methods: Twenty-five patients with primary pterygium and twenty-five with pinguecula were included in the study. In addition, 25 normal subjects were also enrolled as the control group. The AS-AF characteristics of pterygium and pinguecula lesions were analyzed. The size of lesions displayed in the AS-SLE photography versus the AS-AF images were also compared. AS-AF images were obtained using a Heidelberg retina angiograph which focused on the anterior segment. AS-SLE photography was acquired using a digital imaging system (BX900 HAAG STREIT). Results: There were 44 (58.7%) male and 31 (41.3%) female patients; 19 (76%) and 20 (80%) patients had bilateral pterygium and pinguecula, respectively. All pinguecula lesions reflected hyperautofluorescence pattern in the AS-AF imaging. In 24 (96%) patients, the hyperautofluoresecence pattern was larger than the size of the clinical lesions displayed with the AS-SLE photography. Twenty-one (84%) patients with pterygium reflected a hyperautofluorescence pattern in AS-AF images; in one (4%) patient, the hyperautofluorescence pattern was larger than the clinical lesion size and four (16%) patients had no autofluorescence patterns in the AS-AF images. In the control group, in 14 (56%) subjects, a hypoautofluorescent pattern was revealed in the conjunctiva in AS-AF images. However, in 11 (44%) patients, hyperautofluorescence patterns were detected. Conclusion: AS-AF is a useful modality to monitor vascularization in conjunctival lesions. Pingueculae and pterygium show hyperautofluorescence in AS-AF imaging. The real size of the pinguecula lesions may be estimated with AS-AF characteristics, mostly presenting larger than the area size in AS-SLE photography. The autofluorescence size of the pterygium is smaller than the extent of visible pterygium in slit-lamp photography.

Pterygium surgeries at a tertiary hospital, southwest Nigeria: a four-year review

Background: Over the years several pterygium surgical techniques have been developed with the aim of having the least possible recurrence rate. This has been from bare sclera excision which had an unacceptable recurrence rate to the current use of conjunctiva autograft with or without various adjuncts. This study was to review the current practice in a typical multi-specialist ophthalmic department. Method: The ophthalmic theatre operating register was retrospectively reviewed to obtain information on all patients who had pterygium excision at the University College Hospital, Ibadan, over a 4-year period from January 1, 2014, to December 31, 2017. Results: A total of 324 pterygium surgeries were performed and final analysis was on 249 (76.9%) surgeries which met the inclusion criteria, male to female ratio of 0.96:1. The commonest surgical technique was excision + 5-Flourouracil (5FU) + conjunctival autograft accounting for 187(75.1%) eyes. In total, postoperative recurrence was recorded in 40 (16.1%) eyes. The subgroup of excision + 5FU + autograft had the least recurrence rate of 18 (9.6%) eyes. Conclusion: A significant majority of the excision was with conjunctiva autograft with an acceptable low recurrence rate compared with most studies

Prevalence and severity of pterygium among commercial motorcycle riders in south eastern Nigeria

Background: Pterygium is common among outdoor workers who are daily exposed to sunlight and dust due to repeated conjunctival /corneal drying and microtrauma especially in the tropics. Commercial motorcyclists in Nigeria are outdoor workers who spend the greater part of the day outdoors under the intense heat and dust characteristic of this part of the world and would therefore be largely predisposed to developing this conjunctival disorder. Objective: The aim of this study is to determine the prevalence and severity of pterygium among these workers and relate these findings to their duration of work. Methods: A cross sectional study with a multi stage random sampling design was used to choose the 615 subjects enrolled in the study. Results: The prevalence for pterygium was 19.3 (206 eyes) with stage 1 occurring mostly (52) followed by stage 2(46). Pterygium was common among riders who had been riding for 5 years or less. The relationship between duration of riding and pterygium severity was significant (p=0.009). This prevalence was unaffected by the use of regular sun glasses (p=0.188). Conclusion: A strong relationship exists between commercial motorcycle riding and development of pterygium not affected by using regular sunglasses. We recommend that helmets with full face shields and/or proper UV protected riding goggles where the helmets have no face shield be enforced by the regulation bodies so as to reduce the prevalence of these disorders

Simplified and Safe Pterygium Surgery in Nigerians

Objective: To advocate a simplified and safe method of pterygium surgery to Ophthalmologists in Nigeria. Methods: After the routine standard preparation of the eyes for pterygium excision; 114 eyes that had the new procedure did not have the head of the pterygium shaved off the cornea with blade or knife in the usual standard manner; but was avulsed off the cornea unto the sclera . The cornea was then polished with the rough side of a broken ordinary razor blade. The pterygium was excised with a curved conjunctival scissors. Haemostasis and mitomycin C application were carried out in the usual standard manner. Results : All the 114 eyes that were operated using the new procedure had satisfactory cosmetic outcome of the pterygium excision and there was no complication encountered. Conclusion: The simplified method is both safe and effective for pterygium surgery

Prevalence of Pterygium in a Rural Community of District; Southern Ethiopia

Background: Pterygium is principally prevalent in tropical Africa. Though Ethiopia is located in the tropics; the prevalence of pterygium has not been well studied previously. Aim: To determine the prevalence of pterygium among people older than 20 years and its association with age; sex; smoking and exposure to ultraviolet light (UVL) in Meskan District of Gurage zone; Southern Ethiopia. Methods: This cross-sectional study was conducted from March 15 to May 15; 2006. Two peasant associations (PA) were randomly selected from the total of 42 in the district. Based on the sampling fraction; every third household in the selected peasant associations was included in the study. All individuals above 20 years of age in the selected households were interviewed and examined for the presence of pterygium. Measurements of pterygium were made with ruler. Visual acuity was taken for those individuals with pterygium and checked with pinhole if found to be less than 6/18. Results: A total of 922 individuals; 400 (43.4) males and 522 (56.6) females; were involved in the study. The mean age was 38.2 ranging from 21-95 years. Pterygium was found in 81 (8.8; 95CI: 7.0;10.6) of the study subjects. For those individuals whose age was above 40 years; the prevalence was found to be 17.4indicating an increased risk with age (p0.001). It also occurred among 50 (12.5) males and 31 (5.9) females and the difference was statistically significant (p0.001). Males have about twice the risk of developing pterygium compared to females. Conclusion: The prevalence of pterygium obtained (8.8) from this study was relatively low compared to many other reports from tropical areas. However; in agreement with other reports; advancing age and males have been identified as risk factors for the development of pterygium. Pterygium was associated with visual impairment in 13.1of cases

Pterygion; diagnostic et traitement

Le traitement le plus logique et le plus simple du pterygion serait de l'enlever sans qu'il se produise. La hantise de redicives malignes iteratives met l'ophtalmologiste dans une situation embarassante: operer precocement un ptegyrion qui resterait stationnaire sans intervention ou; l'oppose; attendre des signes evolutifs; mais risquer alors des redicives malignes. Le nombre des methodes therapeutiques justifie la complexite du probleme. Ce traitement peut etre prophylactique; medical ou chirugical

Survey of patients attending the eye clinic during the month of March; 1992

An audit survey was carried out during the month of March 1992 of patients attending the eye clinic. The number of patients; age and sex distribution; diagnosis; treatment modality and disposal were recorded. A total of 1166 patients were seen. The commonest diagnosis seen by the Ophthalmologist was non specific; and the commonest by the optometrist was presbyopia. Diseases required treatment included cataract; glaucoma and pterygium. Conditions that require screening included glaucoma and diabetic retinopathy. Prevention could be instituted in reducing other common conditions such trauma; pterygium and toxoplasma chorioretinitis