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Pterygium: are we any closer to the cause?
  1. Jern Chen1,
  2. Sundas Maqsood1,
  3. Stephen Kaye1,2,
  4. Adrian Tey1,
  5. Sajjad Ahmad1,2
  1. 1St Paul's Eye Unit, Royal Liverpool University Hospital, Liverpool, UK
  2. 2Department of Eye and Vision Science, University of Liverpool, Liverpool, UK
  1. Correspondence to Sajjad Ahmad, Department of Eye and Vision Science, University of Liverpool, 3rd Floor UCD Building, Daulby Street, Liverpool L69 3GA, UK; Sajjad.Ahmad{at}liverpool.ac.uk

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Pterygium is derived from pteron, the Greek word for wing. It is an abnormal wing-like growth that can be found on the neck, at joints and between digits, as well as on the eye (these pterygia are not necessarily related to each other). Man has recognised it as an ocular surface disease for many centuries (it is interestingly almost exclusive to humans). Indeed Egyptian papyri from as far back as 1600–1300 BC show that pterygia were not an infrequent abnormality then. Epidemiological studies now show that its prevalence varies from as low as 0.7% in Denmark (n=810) and 1.1% in non-Aboriginal Australians (n=40 799) to as high as 30.8% in Japan (n=3762) and 33.01% in China (n=4214).1

As ophthalmologists we obviously recognise pterygium as an abnormal triangular non-malignant fibrovascular mass most often on the nasal aspect of the conjunctiva and cornea. This is associated with inflammation and neovascularisation. Moderate disease results in increasing regular and irregular astigmatism and in severe cases there is loss of corneal transparency. The mainstay of conventional definitive treatment is surgical. If the pterygium is either excised alone (bare sclera technique) or if the conjunctival edges are sutured, there is a recurrence rate of 30–70%.2 To reduce recurrence, we have effectively developed certain adjunctive measures including replacing the limbal-conjunctival defect with a conjunctival autograft3 or amniotic membrane4 (less than 10% recurrence). Recent modifications to this include the …

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