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    Yulia Pterygium

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    Melly Fitriany Syam
    This document discusses pterygium, a triangular fibrovascular growth on the eye. Pterygium is caused by factors like UV exposure, dryness, and genetic mutations. It begins as a small growth but can advance and invade the cornea. Symptoms include irritation, redness, tearing. Treatment depends on size and symptoms - observation for small asymptomatic cases, eye drops for larger cases, and surgery for large or symptomatic pterygium covering the visual axis. Surgical techniques aim to remove the growth and cover the bare sclera left behind, but have recurrence rates ranging from 5-82% depending on technique and primary vs recurrent pterygium.

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    Yulia Pterygium

    Uploaded by

    Melly Fitriany Syam
    104 views22 pages
    This document discusses pterygium, a triangular fibrovascular growth on the eye. Pterygium is caused by factors like UV exposure, dryness, and genetic mutations. It begins as a small growth but can advance and invade the cornea. Symptoms include irritation, redness, tearing. Treatment depends on size and symptoms - observation for small asymptomatic cases, eye drops for larger cases, and surgery for large or symptomatic pterygium covering the visual axis. Surgical techniques aim to remove the growth and cover the bare sclera left behind, but have recurrence rates ranging from 5-82% depending on technique and primary vs recurrent pterygium.

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    This document discusses pterygium, a triangular fibrovascular growth on the eye. Pterygium is caused by factors like UV exposure, dryness, and genetic mutations. It begins as a small growth but can advance and invade the cornea. Symptoms include irritation, redness, tearing. Treatment depends on size and symptoms - observation for small asymptomatic cases, eye drops for larger cases, and surgery for large or symptomatic pterygium covering the visual axis. Surgical techniques aim to remove the growth and cover the bare sclera left behind, but have recurrence rates ranging from 5-82% depending on technique and primary vs recurrent pterygium.

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as ppt, pdf, or txt
    104 views22 pages

    Yulia Pterygium

    Uploaded by

    Melly Fitriany Syam
    This document discusses pterygium, a triangular fibrovascular growth on the eye. Pterygium is caused by factors like UV exposure, dryness, and genetic mutations. It begins as a small growth but can advance and invade the cornea. Symptoms include irritation, redness, tearing. Treatment depends on size and symptoms - observation for small asymptomatic cases, eye drops for larger cases, and surgery for large or symptomatic pterygium covering the visual axis. Surgical techniques aim to remove the growth and cover the bare sclera left behind, but have recurrence rates ranging from 5-82% depending on technique and primary vs recurrent pterygium.

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    of 22

    PERTUMBUHAN

    JARINGAN
    FIBROVASKULER
    BERBENTUK SEGITIGA
    DENGAN APEKS
    SELALU DI KORNEA
    BERSIFAT
    DEGENERATIF DAN
    INVASIF

    MUTASI GEN P53


    PAPARAN UV
    PAPARAN ANGIN
    MENURUNKAN
    APOPTOSIS
    PAPARAN DEBU
    MENINGKATKAN
    KELEMBABAN UDARA
    TGF-b
    YG KURANG
    PTERYGIUM
    DRY EYE SYNDROME

    LIMBAL STEM CELL


    DEFFICIENCY

    Elastotic degeneration
    fragmentation and breakdown of
    stromal collagen

    Destruction of Bowmans layer by


    advancing fibrovascular tissue
    resulting in corneal scarring

    in the advancing head of a pterygium,


    conjunctival-like epithelium (Conj) merges
    abruptly into corneal epithelium (Corn).
    The underlying Bowman's layer (arrows)
    is fragmented and precedes a fibrovascular
    stroma (asterisk).

    Goblet cell hyperplasia is apparent in


    pterygium (B), compared with donormatched conjunctiva (C).

    Prominent central feeder vessel; inset


    shows dilated subepithelial vessels

    E: Elastotic changes (double asterisk) in


    pterygium stroma.
    F: Inflammatory infiltrates in the epithelium.
    G: Stromal vessels loaded with
    polymorphonuclear leukocytes.

    Note the severe solar elastosis


    beneath the epithelium on the
    right-half of this
    photomicrograph.
    The dilated vessels beneath the
    epithelium to the left
    correspond to the "injection"
    seen clinically

    Grading of pterygium helps for


    management
    Depending on SizeGrade 1

    Grade 2

    Grade 3

    Variants
    Cystic degeneration
    Bidirectional
    Pseudo pterygium present anywhere, neck bridges limbus
    05/25/15

    14

    Observation
    Asymptomatic , grade 1 pterygium

    Medical Management
    Symptomatic Grade 1 and 2 pterygium

    Eye drops Tear substitutes, Decongestants


    Local injections anti VEGFs, Steroid

    Surgical Management
    05/25/15

    19

    No sutures or fine,
    absorbable sutures used
    to appose conjunctiva to
    superficial sclera in
    front of rectus tendon
    insertion
    Leaves area of bare
    sclera
    Relatively high
    recurrence rate with
    variable techniques of 5
    68 % with primary / 35
    82 % with recurrent)

    Indications Symptomatic patients


    - recurrent irritation, redness and watering
    Visual need
    - covering visual axis or threatening visual
    axis
    - causing irregular astigmatism
    - Grade 2 and 3 Pterygium
    Cosmetic
    Therapeutic
    - suspected associated neoplastic degeneration
    - motility restriction
    05/25/15

    21

    Reported recurrence rates are


    variable (between 0 40 %)
    Few complications
    Further prospective studies in
    primary and recurrent pterygia are
    needed

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