How to protect your eyes from pterygium. Is pterygium of the eye a cosmetic defect or a dangerous disease? Pterygium: characteristics of the disease

Pterygium is a pathological fold of the conjunctiva that gradually grows onto the cornea. Most often, pterygium of the eye can occur in people who live in the southern part, who spend most of their time outdoors. This problem is caused by solar radiation, dust, and chemical irritants.

Pterygium on the eye

If you are faced with a similar problem, then you should treat pterygium as soon as possible. In this article, we tried to collect all the methods that will help perform high-quality treatment for pterygium of the eye.

Symptoms

In most cases, such a problem can be detected only in the later stages. This is due to the fact that in the initial stages the disease does not cause any discomfort. With the gradual development of the disease, the patient may experience the following symptoms:

• gradual visual impairment;
• increased eye fatigue;
• feeling of dryness;
• sensation of a foreign object in the sclera;
• increased moisture in the tear ducts.

The degrees of pterygium can also vary. The disease can be congenital or acquired. A congenital defect of the sclera is a consequence of an intrauterine viral infection. It is also divided into progressive and non-progressive forms. In the first case, this disease can begin from the edge of the eye and subsequently close it completely.

Causes

To date, ophthalmologists have not yet established the exact cause of the development of this disease. Meanwhile, ophthalmologists managed to identify factors that can lead to the active development of pathology. These factors include:

1. The patient's tendency to persistent diseases of the conjunctiva.
2. The influence of the computer on the organ of vision.
3. Heredity.
4. Eye irritation from wind.
5. Aggressive effects on the organ of vision of ultraviolet radiation.

Patients should also remember that the active development of the disease is completely unaffected by age and gender. The pathogenesis of the problem will look like this. Regular exposure of the conjunctiva can cause an increase in the vascular pattern. Over time, such exposure can gradually cause changes in the epithelium. A large number of vessels further facilitate the penetration of fibroblasts, which will be responsible for the production of epithelial tissue.

Between this, the pterygoid hymen can gradually increase in size or remain unchanged. From the outside, the disease will look like a grayish film.

Classification

The classification may include 5 degrees of development. Moreover, three degrees of development can be cured only with the help of surgery. If you have found a similar problem, then it is not recommended to get upset. See your doctor so he can quickly determine the extent of your problem.

If the growth is small and does not interfere with vision, then treatment can be symptomatic. If certain problems and discomfort arise, pterygium can only be removed surgically. Practice shows that it is best to treat the disease in the early stages. This provides an excellent opportunity to avoid relapses.

Treatment

The disease progresses slowly and in the initial stages does not affect visual acuity at all. In this case, the pterygium of the eye can be removed only for cosmetic purposes. However, if the film gradually grows on the cornea, urgent surgical intervention will be required. In most cases, treatment is carried out under local anesthesia. Specialists will inject a special solution into the thickness of the pterygium. When the anesthetic begins to take effect, the film is removed using a blade, and a bandage is applied to the eye.

You will no longer need to adhere to a special regime. After 10 days you can begin normal work. If the problem is advanced, then the treatment technology will become much more complicated. After eye pterygium surgery, the following precautions should be taken:

• After surgery, you may feel pain as well as discomfort. This happens until the wound has not yet healed. Immediately after healing, the pain will disappear.
• Bleeding may occur within a few hours after surgery. You should not be afraid of this, since it will be enough to simply change the bandage.
• The conjunctiva is then sutured, so you can feel the mote. In a week, the stitches will dissolve and this feeling will disappear.
• If the disease reappears, then surgery will be required again.

Laser removal

For removal, specialists can use a variety of techniques. The most optimal solution is to remove the pterygium with a laser. If the size of the problem is small, then the intervention can be performed under local anesthetic. The operation does not take more than 30 minutes. According to statistics, approximately 40% of patients may experience a relapse.

Laser removal of pterygium

To prevent further relapse, specialists can glue a piece of conjunctival tissue to the affected area. In addition, mitomycin can be used, which will inhibit the active development of tissue. Immediately after removal, anti-inflammatory drops can be used.

Surgery on pterygium should be performed at a time when the film has not yet covered the central area of ​​the cornea. During removal of recurrent pterygium, specialists perform marginal lamellar keratoplasty. Almost immediately after removal, a slight clouding of the cornea may form, which will subside with time.

Postoperative period

Immediately after removing the problem, experts recommend treating the eyes with anti-inflammatory drops. Complications may occur with any treatment. Therefore, you should consult with specialists before surgery.

Use of folk remedies

People who are affected by this disease are visible to the naked eye. First you will need to decide what degree the disease has. The sooner you see a doctor, the faster the problem can be eliminated. To date, there are no folk remedies that could help treat this disease.

If folk remedies do not help at all, then surgery to remove the pterygium will be required. We hope this information was useful and interesting.

General information:

Pterygium(pterygoid hymen) - a triangular-shaped formation, usually in the area of ​​the inner canthus, consisting of degeneratively changed tissue of the conjunctiva of the eyeball, gradually growing from the limbus and the surrounding area towards the center of the cornea. Its size varies from small, not affecting vision, to large, occupying a significant part of the cornea. The course can be either protracted or rapidly progressive, when the pterygium reaches the central optical zone of the cornea in a short time.

Pterygium- this is a pathological growth of the conjunctiva on the cornea. Pterygium gradually progresses and reaches the cornea to the central zone, closing the pupil and, as a result, impairs vision. The part of the pterygium that is fused to the cornea is called the head. The other part, coming from the conjunctiva and penetrated by vessels, is called the body of the pterygium.

There are 3 stages of pterygium: the first is the initial stage (1-2 mm), the second stage, which occurs most often, is 3-4 mm. In the last stage, the pterygium reaches the central optical zone of the cornea

Diagnostics

Pterygium is easily diagnosed by external clinical signs. Often in the area of ​​the inner canthus, consisting of degenerative tissue of the conjunctiva of the eyeball and gradually growing from the limbus and the surrounding area towards the center of the cornea.

It is noted that men are twice as likely to suffer from pterygium than women. The risk of the disease increases with age, with most cases occurring between the ages of 20 and 40 years. Cases of pterygium under the age of 20 have not been reported. Patients complain of the appearance of a formation that looks unaesthetic, causes a feeling of a foreign body in the eye, as well as deterioration of vision or loss of vision (in severe cases). Pterygium can develop in one or both eyes.

Causes

The exact cause of the formation of pterygium is unknown, but its development is associated with constant exposure to dust, wind, and ultraviolet radiation. Pterygium is often diagnosed in people who work at high temperatures (blacksmiths, glaziers), a toxic environment with various fumes and chemical substances, and extreme cold. Genetic predisposition is not the last important factor in the appearance of pterygium.

Methods for preventing the disease are not yet known.

If any changes are detected in the eyes, it is recommended to consult a specialist doctor. It is very important to carry out the operation on time. The earlier the operation occurs, the better the result.

Treatment

Oculus-Prim Medical Center offers treatment depending on the stage of the disease

The surgical intervention is well tolerated by patients; it is performed under local anesthesia, without hospitalization. The operation does not last long and is painless. After the operation, local treatment is performed with antibiotics, anti-inflammatory drugs, and artificial tears.

Pterygium stage III

Reasons for undergoing surgery to remove pterygium:

• Aesthetics, functional (eye movement may be difficult)
• In the second and third stages, vision may deteriorate
• Probability of infection and risk of corneal infection

Surgical interventions vary depending on the stage of pterygium.

Pterygium stage three

First, the head and body of the pterygium are excised from the cornea, after which the body is removed and the surface of the sclera is cleaned of pathological tissue. There are several options for completing the operation to remove pterygium:

• The sclera remains uncovered;
• Covered by the adjacent conjunctiva (only in case of small pterygiums, to avoid the risk of recurrence)
• A graft is used, formed from the conjunctival tissue of the same eye, from under the eyelid (the operation lasts longer, but the risk of relapse is lower), which will close the defect; in more complex cases and in young patients, it is possible to apply a substance to the sclera for 5 minutes that reduces the development pathological tissue, thus reducing the risk of relapse.
• In case of relapses, a corneal lamellar transplant and an amniotic membrane transplant are used to cover the surface of the conjunctiva.

Pterygium stage I Pterygium stage II

Postoperative period: the first few days after surgery, the eye becomes red, may water and hurt. These symptoms gradually subside as the surface of the cornea and the site from which the graft was taken heal. After surgery to remove pterygium, the patient may need an eye patch or a therapeutic contact lens for a few days. Between 2 and 3 weeks after surgery, swelling of the graft forms, which resolves after treatment. Postoperative complications are rare: corneal infections, graft suture rupture, corneal astigmatism.

A triangular growth that forms on the inside of the conjunctiva is called a pterygium of the eye. This is a common ophthalmic disease that often does not cause discomfort, but as the disease progresses and the formation increases in size, visual function deteriorates. In such cases, surgery is prescribed to remove the pterygium, after which rehabilitation and recovery will be required.

According to the international classification of diseases ICD-10, the pathology is assigned code H11.0 Pterygium.

Main causes

Pterygium appears as a triangular film on the eye, which is formed from degenerative changes in the bulbar conjunctiva. The formation has its own structure and consists of a head, neck, and body. The pathology often occurs on the cornea of ​​both eyes after the age of 40; it is rarely diagnosed in children. The reasons for the development are:

• Hereditary predisposition. If a child has this eye pathology in the family, the risk of its development at an older age increases.
• Often recurrent conjunctivitis. It is important to treat such an infectious disease correctly, otherwise degenerative processes will begin to progress on the cornea, leading to pathological changes in the corneal tissue.
• Aggressive influence of natural factors - ultraviolet rays, wind, dust. Eye pathology is often diagnosed in residents of southern countries and regions where the climate is dry, hot and windy.

A common cause of pterygium is increased load on the visual organs and constant stress, for example, if a person’s work is related to a computer. In this case, the moisture supply to the conjunctiva is disrupted, dry eye syndrome progresses, untimely treatment of which leads to inflammation and the development of eye pathology.

Classification

The disease has the ability to progress. The growth rate of pterygium can be predicted by the condition of the blood vessels. According to this criterion, 3 degrees of development are distinguished:

1. The growth is still transparent, the vessels can be clearly seen in it, and the risk of progression is minimal.
2. The formation is translucent and protrudes above the cornea. The vascular network is partially visible, the disease is prone to further development.
3. The activity of enlargement of the pterygium is large, the growth is opaque, the vessels on it are not visible.

According to this classification, the disease occurs:

• progressive;
• stationary.

Taking into account the prevalence of formation, the magnitude of astigmatism and visual impairment, 5 stages of pathology development are distinguished:

1. The initial stage is characterized by the formation of a pterygium at the limbus; there are no pronounced symptoms.
2. The film reaches the edge of the pupil. Astigmatism appears and vision deteriorates.
3. Progressive grade 3 is characterized by growth of the growth to the edge of the pupil and a significant decrease in visual acuity.
4. The formation reaches the projection of the center of the pupil, astigmatism progresses, visual function is severely impaired.
5. At the last stage, the pterygium extends beyond the center of the cornea and spreads further. There is no refraction, vision is completely impaired, the conjunctiva fuses with the mucous membrane of the eyelids.

How to recognize: main symptoms

The growth is often localized in the inner, nasal side of the eyelid, but there are situations when the film covers the cornea on both sides at the same time. At the initial stage, pterygium of the eye does not cause discomfort or other unpleasant symptoms. However, as the pathology progresses, the signs become more pronounced. The person is concerned about:

• feeling of the presence of a foreign body under the eyelid;
• severe dryness and irritation of the mucous membranes;
• inflammation of the conjunctiva;
• edema formation;
• redness and itching;
• increased lacrimation;
• astigmatism;
• decreased visual function.

Diagnostics

If you are concerned about the characteristic symptoms of pterygium, you should not self-medicate. It is necessary to urgently visit a doctor, find out an accurate diagnosis, and try to find out the reasons for the development of the disease. An ophthalmologist will treat the disease. The doctor will conduct an initial examination, collect anamnesis, and then give a referral for a number of diagnostic procedures such as:

• biomicroscopy;
• ophthalmoscopy;
• visometry;
• refractometry;
• keratotopography;
• fluorescein angiography.

What treatment is prescribed?

Drugs

If the pterygium does not progress, the formation is stable and does not increase in size, conservative treatment is carried out. Medications are not able to get rid of pathology; they are used to eliminate severe symptoms, inflammation, and discomfort. Ophthalmic drops, ointments and gels with antibacterial, anti-inflammatory, analgesic, moisturizing and nourishing effects are often used.

Surgery

If the disease progresses and the growth increases, the doctor will recommend removing it. Pterygium removal is often performed with conjunctival plastic surgery. Before surgery, the patient is given local anesthesia, after which the growth is removed. The operation is simple; immediately after the anesthesia takes effect, the doctor excises the pathological tissue and covers the area where it was located with healthy tissue. Thus, it will be possible to prevent the recurrence of pterygium and achieve a cosmetic result. The doctor attaches healthy conjunctival tissue to the mucous membrane, applying 6 sutures or using special glue, which reduces postoperative discomfort and speeds up recovery. To avoid relapses, Mitomycin-S drops are instilled into the eyes immediately after surgery.

During the rehabilitation period, it is worth taking precautions to help avoid the development of complications. After surgical treatment in the first 2-3 weeks it is prohibited:

Perform heavy physical activity;

All materials on the site were prepared by specialists in the field of surgery, anatomy and specialized disciplines.
All recommendations are indicative in nature and are not applicable without consulting a doctor.

Pterygium is an ophthalmic disease in which the well-supplied fold of conjunctiva that covers the cornea grows. Surgical removal of pterygium is the main method of combating pathology.

The exact cause of pterygium has not been established, but it is known to occur more often in people living in sunny and dusty regions, as well as in those who work outdoors and in the sun. Of no small importance are low or too high ambient temperatures, toxins, and chemical reagents in the atmospheric air. Genetic predisposition, infection with oncogenic viruses, and the presence of dry eye syndrome play a certain role.

Pterygium causes a visible cosmetic defect and is fraught with serious complications. It is a triangle in the inner corner of the eye, which consists of dystrophically changed mucous membrane, which slowly moves from the limbus towards the central part of the cornea.

In the mechanism of pathology development, an increase in the activity of cell division in the mucosa, as well as the abundant proliferation of the vascular network, is of great importance, therefore the purpose of surgical removal is not only to excise the tumor, but also to prevent the re-growth of active tissue.

The thin part of the fold that fuses with the cornea is called the head of the pterygium, and the conjunctival fragment, rich in vessels, is its body. A significant area of ​​the pterygium disrupts the refractive function of the cornea and creates a mechanical obstacle to the path of the light beam, causing vision to suffer. The pathology can affect one eye or both at the same time.

Pterygium can take a long time to develop, but in some cases it reaches the pupil in a matter of months. Patients usually come to an ophthalmic surgeon already in the second stage of the disease, when the width of the pathological fold reaches 4 mm. Among those who asked for help, there are twice as many men, the average age is 20-40 years, that is, young able-bodied people have to be operated on.

Indications, contraindications and preparation for surgery

The reason for surgical excision of the pterygoid hymen is considered to be the very presence of pathology, a cosmetic defect created by a fold on the cornea, and especially advanced stages when vision suffers. Pterygium creates an increased risk of secondary inflammation and infection, so surgeons prefer to rid the patient of it.

Indications for pterygium removal:

• Diagnosed with stage 2 or 3 pathology;
• Rapid progression of grade 1 pterygium;
• The patient’s personal desire to get rid of mucosal proliferation, regardless of the particular course and stage.

Operation contraindicated persons with acute inflammation of the membranes of the eye, in the presence of herpetic infection in the acute stage. An obstacle may be an allergy to local anesthetics and refusal of surgery on the part of the patient.

The pterygoid fold grows from the limbus - the inner part of the eye up to one and a half millimeters wide, in which the mucous membrane and sclera are connected and due to which the corneal epithelium grows.

The pterygoid fold of the conjunctiva can only be removed surgically, Conservative treatment does not bring results, however, despite the abundance of surgical techniques, the risk of relapse is still quite high - up to 40%. Moreover, the relapse is more severe than the initially occurring pterygium. There are patients who experience numerous relapses, and the number of operations reaches a dozen or more.

In order to somehow prevent the recurrence of pterygium, ophthalmologists supplement traditional surgery with radiation therapy, treatment with antimetabolites, and transplantation of fragments of the patient's own mucosa or amniotic membrane.

Amniotic flaps help reduce the risk of recurrence, but can cause a serious immune reaction. Radiation therapy triples the risk of recurrence of pathology, but is risky for secondary glaucoma, clouding of the lens, perforation of the cornea, and softening of the sclera.

Preparation The operation includes a consultation with an ophthalmologist and a thorough examination, which consists of examination, biomicroscopy, coherence tomography of the eye, and determination of visual acuity. The patient undergoes standard general clinical tests, undergoes tests for HIV, hepatitis, syphilis, and blood clotting tests. An examination by a therapist is required to rule out possible contraindications from internal organs.

Before the operation there are no restrictions on nutrition or fluid intake, but you will have to exclude any cosmetics and perfumes. You should not drink alcohol the day before; it is better to give up smoking for good. On the morning of the intervention, wash your face with plain water. It is worth bringing sunglasses with you to the clinic, which will be very useful on the way home.

Features of surgery for pterygium

The operation to remove pterygium does not require hospitalization and is performed on an outpatient basis and under local anesthesia with special eye drops. It lasts about half an hour, possibly longer, depending on the technique chosen by the surgeon.

Operations for pterygium are carried out in two stages:

1. Separation of growths from the surface of the eye;
2. Excision or movement of the separated fold and closure of the resulting defect in the mucous membrane.

According to the degree of complexity of surgical intervention, all operations for pterygium can be divided into three main types:

• Interventions with removal of pterygium.
• Surgical relocation of the pathological fold.
• Plastic surgery of conjunctival defect.

Operations to remove pterygium - the simplest ones. Abroad, they are produced with the sclera exposed, cutting off the body and head of the formation and leaving an area of ​​exposed sclera. Regeneration occurs before the mucosa grows to the limbus. The operation would have been good if not for a relapse, which develops in 9 out of 10 people operated on.

The so-called closed scleral exposure differs from the technique described above in that the wound edges of the conjunctiva are fixed with several sutures. The risk of relapse is up to 70%.

The second type of operations are techniques with pterygium relocation without cutting it off. The most famous method is according to McReynolds. It gives a relatively small percentage of relapse - up to 12.5%. The operation includes several successive stages:

1. Treatment of the skin with ethanol and iodine, instillation of an antiseptic into the conjunctival sac, anesthesia with drops of dicaine;
2. Fixation of the eye with an eyelid speculum;
3. Anesthesia of pterygium tissue by injecting novocaine with adrenaline into it (the latter has the necessary vasoconstrictor effect);
4. Grasp the head of the pterygoid fold with tweezers and carefully separate the tissue from the cornea with excision of the main mass of the pterygium;
5. The conjunctival membrane is incised with scissors and separated to the lower fornix of the eyelid;
6. Apply a suture to the head of the pterygoid fold and turn it inside out into the pocket of the mucous membrane.

removal of pterygium according to McReynolds

The graft of the transplanted mucosa should not cover the cornea or leave a strip of open sclera; it is transplanted strictly onto the exposed limbus. The operation is completed by washing the conjunctival cavity with an antiseptic, placing tetracycline ointment behind the eyelids and applying a sterile bandage.

The described operation for pterygium is not without its drawbacks., the main of which are the so-called corneal syndrome and the inflammatory process, leading to subsequent relapse of pterygium. Corneal syndrome occurs early after surgery due to erosion of the mucosa at the time of separation of the pterygoid fold from the cornea. Damage to small nerve fibers, pain, and spasm of the muscle fibers of the eyelids are the basis of corneal syndrome.

Another disadvantage of the McReynolds technique is that the limbus and pterygoid fold damaged by surgical incisions are not separated and cannot regenerate separately. Under such conditions, the healing mucous membrane can grow back into the corneal defect and relapse.

Suggestions from ophthalmic surgeons regarding the prevention of the described complications consist in the separation of the elements of the eye that have undergone surgical incisions, and the use of soft lenses covering the cornea, which is devoid of the epithelial layer.

Third group of operations for the removal of pterygium includes techniques with removal of the formation and subsequent plastic surgery of the mucous membrane with one’s own or donor tissue.

Removal of pterygium according to Arlt involves excision of the newly formed tissue, a section of the scleral mucosa and the application of several sutures to the wound edges of the mucosa. The disadvantage of the intervention is the removal of a section of the conjunctiva, which can significantly complicate reoperation in case of relapse, which develops in about a third of those operated on.

removal of pterygium according to Arlt

After removing the pterygium, foreign specialists perform plastic surgery using the patient’s own mucous membrane, which is cut out from different parts of the conjunctiva of the eyeball. Attempts are being made to use the femtosecond laser to obtain a mucosal graft. The probability of relapse is 40%.

Attempts to avoid recurrence led to the refusal of some surgeons to use any sutures. They fix the mucous flaps with special fibrin glue, which not only facilitates the operation and subjective discomfort after treatment, but also makes it less likely that the pterygium will re-grow compared to suture techniques. The disadvantages of fibrin glue are insufficient fixation and divergence of the wound edges, the possibility of cyst formation, and pain.

Surgical research aimed at improving long-term treatment outcomes continues. There is evidence of the use of extended conjunctival graft transplantation, in which the risk of relapse is almost zero, but such an operation is not yet widely used. It is possible to use the amniotic membrane "Flexamer".

Plastic surgery with your own mucosa or amniotic membrane after removal of pterygium can lead to complications, including:

• Impaired sensitivity of the superficial tissues of the eyeball;
• Inflammatory process.

It is easy to notice that any type of surgical treatment of pterygium is fraught, first of all, with relapse. This is the most common complication encountered by ophthalmic surgeons, and its risk depends on the method of surgery performed, the individual characteristics of the patient’s tissues, his lifestyle and type of activity. The skill of the surgeon is of a certain importance. According to statistics, the lowest risk of relapse comes from operations followed by plastic surgery of the mucosal defect using one’s own tissues.

Recovery after surgery

After surgery there is no need to stay in the clinic, so the patient can go home. It is better to be accompanied by someone close to you. You won't be able to drive. During healing, pain, pain in the eyes, discomfort during visual stress, and lacrimation may occur.

In the postoperative period, the patient continues treatment aimed at preventing relapse. Considering the mechanisms of pathology development, it is advisable to use radiation and chemotherapy treatment. Radiation therapy causes complications in the form of mucosal ulcerations and cataracts, so most experts are inclined to chemotherapy as safer and more effective. The patient is prescribed mitomycin C and cyclosporine A.

At home, the operated patient takes care of his eyes independently, instills anti-inflammatory, antibacterial and other drugs recommended by the attending physician. If possible, it is worth minimizing eye strain so as not to provoke excessive dryness of the cornea.

During the first two weeks, you should carefully monitor your eye hygiene. exclude the use of any cosmetics and foreign bodies, as well as water. Do not rub your eyes or touch them with your hands. To ensure proper and timely regeneration, you need to avoid exposure to bright sun, exposure to smoke and dust.

Recommendations regarding lifestyle, sun exposure, exposure to wind and dust apply not only to the rehabilitation period. They will need to be observed at all times. If pterygium often recurs, and this is associated with professional activity (hot workshops, dusty industries, agriculture), it makes sense to think about changing jobs in order to maintain eye health.

Video: pterygium of the eye, surgical removal of pterygium

Video: pterygium in the program “Live Healthy!”

Pterygium is an ugly growth on the skin that causes discomfort. Many people do not pay attention to this disease, considering it a cosmetic defect that does not require special treatment. But is this really so?

Pterygium is a disease of the conjunctiva (mucous membrane) of the eye, in which its tissue changes and grows on the cornea. Such growth most often occurs from the medial (inner) corner of the organ of vision. In most cases, both eyes are affected. Experts also call pterygium pterygium or pterygoid hymen. The formation has a triangular shape, gradually growing towards the pupil.

Pterygium is a wing-shaped formation

In addition to a cosmetic defect, the pterygoid hymen causes discomfort and ultimately reduces visual acuity.

The disease is more susceptible to older people, residents of northern and southern latitudes, as well as people whose eyes are constantly exposed to various irritants.

Pterygium: video

Classification of the disease: false and true pterygium

Pterygium is classified according to its origin, progression and clinical development.

There are primary (true) and secondary (false) pterygium. True occurs primarily in older people as a result of exposure to harmful factors on the mucous membrane of the eye. Secondary, also called pseudopterygium, develops as a result of cicatricial changes in the conjunctiva due to various injuries, surgeries, burns, and inflammations. False pterygium differs from true pterygium in that it does not progress and can be located anywhere in the eye.

Depending on the tendency to progression, there are:

Clinically, pterygium is divided into five stages depending on visual impairment, depth of ingrowth and developed astigmatism.

Why pathology occurs: development factors

The histological prerequisite for the development of pterygium is the same origin of the stratum corneum and conjunctival tissue. Hereditary predisposition plays a significant role in the occurrence of the disease.

Experts cannot name the exact reasons causing the pathology. There are factors that provoke the occurrence and progression of pterygium:

The occurrence of pterygium provokes chronic irritation of the eyes by harmful substances

The constant influence of harmful factors on the eyes provokes inflammation of the conjunctiva, changes in the epithelial layer of the outer layer of the eye and the proliferation of small blood vessels. Due to increased blood circulation in the eye shell, corneal keratocytes are activated - cells related to fibroblasts (the “building blocks” of the body’s connective tissue). They cause the proliferation of connective tissue, from which the pterygoid hymen is formed.

Symptoms of pterygium: degrees and stages of occurrence

At the very beginning, the disease does not manifest itself with any unpleasant symptoms. The first sign of pterygium is clouding of a small area of ​​the edge of the cornea, then a small formation appears in this place, which gradually grows.

As the hymen enlarges, the patient begins to be bothered by the feeling of a speck in the eye and persistent discomfort. These unpleasant symptoms occur due to irritation of the nerve endings on the inner surface of the eyelid. Constant dryness and burning are caused by a disruption in the formation of the physiological moisturizing film on the eye. The more the pterygium grows, the more severe the symptoms become. When the formation grows on the central part of the cornea, visual acuity decreases. Sometimes the pterygoid hymen becomes inflamed and then swelling of the conjunctiva, redness of the sclera, itching and lacrimation occur.

Pterygium of the eye stage 3

The pterygium has three parts: body, head and cap. The anterior flat edge or cap is the tip of the hymen and is composed of fibroblasts that germinate and destroy the corneal membrane. Behind the cap is a head with a developed network of small vessels, which tightly fuses with the cornea of ​​the eye. The body of the hymen is the largest mobile part of the pterygium.

The progressive form of the disease is characterized by a thickened head protruding above the surface of the cornea and a developed vascular network. Based on the condition of the vessels of the hymen, doctors determine its ability to grow:

There are five clinical stages in the development of the disease:

Diagnosis of pterygoid hymen

It is quite simple for an ophthalmologist to diagnose pterygium, since the hymen is well defined visually. Usually, the doctor performs ophthalmoscopy, biomicroscopy using a slit lamp, and keratotopography (scanning the surface of the cornea). These examination methods allow the specialist to determine the condition of the fundus of the eye, the level of astigmatism caused by the disease, as well as assess the lesion and the degree of fusion of the hymen with the stratum corneum.

Photo gallery: examination of the patient

Ophthalmoscopy - examination of the fundus of the eye Biomicroscopy using a slit lamp is used to examine different parts of the eyeball Keratotopography - examination of the surface of the cornea

Differential diagnosis

Pterygium should be differentiated from the following eye diseases:

Treatment of the disease: are folk remedies effective?

The only complete treatment for pterygium is surgery. Drug treatment, and especially folk remedies, cannot completely get rid of the problem.

Use of medications

Conservative treatment is prescribed to alleviate symptoms and slow down the growth of the pterygoid hymen.

The pterygium should be measured periodically to determine the rate at which the formation is growing: first every 3 months, then once a year.

To reduce eye irritation, artificial tear preparations are prescribed: drops Oxial, Hypromelose, Defislez, Slezin, Hilo-Komod, Visin, eye gels - Oftagel, Vidisik, Systein-gel.

For moderate or severe inflammation of pterygium, weak local steroid drugs are prescribed: fluoromethanol solution, loteprendol solution, Dexamethasone drops. Non-steroidal anti-inflammatory drugs are used: Diclofenac, Nevanac, Broxinac drops.

In some cases, Dexamethasone is prescribed as an injection into the body of the hymen in a two-time course of 10 injections with a one-month break. As a result, flattening and atrophy of the body of the ptegirium and disruption of its blood supply are observed. This therapy is indicated for the treatment of stage 1 disease.

To slow down the growth of the pterygoid hymen, the drug Emoxipin (Lakemox), a synthetic antioxidant, is used. For the same purpose, vitamin preparations are recommended - Choline, Riboflavin, instilled into the eye. These agents, by improving metabolic processes in the cornea, slow down the growth of pterygium. Injections of hyaluronidase inhibit the development of connective tissue, thereby helping to stop the growth of the hymen. This therapy is effective only for grade 1–2 of the disease; with severe severity of pterygium, it can only serve as an addition to surgical treatment.

Photo gallery: drugs for the symptomatic treatment of pterygium

Visine is prescribed to eliminate symptoms of dryness and irritation of the eyes. Drops Oxial - to moisturize the cornea.
Oftagel drops are prescribed to moisturize the cornea of ​​the eye Broxinac drops are necessary to relieve inflammation and pain Systane ultra drops to eliminate dry eye syndrome Diclofenac eye drops are prescribed to relieve inflammation
Emoxipine is prescribed to slow the growth of pterygium
Dexamethasone in eye drops has an anti-inflammatory effect

Surgical treatment: methods for removing pterygium

Surgical treatment is carried out both for cosmetic purposes and as necessary if the enlarged hymen has reached the optical part of the cornea, due to which vision is steadily declining and the patient experiences severe discomfort.

Contraindications to surgery to remove the pterygoid hymen:

Modern surgical ophthalmology can offer many techniques for removing pterygium. All of them are aimed at excision of formation. However, pterygium is prone to relapses, more aggressive than the initial case, so conventional tissue removal is ineffective.

Surgery to remove pterygium using layer-by-layer barrier keratoplasty

The technique of excision of pterygium tissue is often used, followed by closing the site of the pterygoid hymen with a conjunctival autograft (a section of healthy conjunctiva extracted from under the upper eyelid) or amniotic membrane. Sutures or special biological glue are used to secure the material to the wound.

Surgery to remove pterygium using an autograft

There is an interesting technique for preventing the recurrence of petrigium. The hymen is excised, a special film is applied to the “bare” area of ​​the sclera, which contains Mitomycin-c (an antitumor antibiotic) or 5-Fluorouracil (antimetabolite), it is fixed, and the rest of the wound is covered with healthy conjunctiva. A week after the operation, the film is removed. This method allows not only to avoid relapses, but also gives a good cosmetic effect due to complete epithelization of the wound.

Applications of 20% ethanol are also used to the body of the pterygium before removal and to the sclera after excision. This method is comparable in effectiveness to the use of Mitomycin, and healing of the cornea occurs even faster.

The operation itself is performed on an outpatient basis, under local anesthesia and lasts about half an hour. 2 hours after the procedure, the patient can return home. The duration of sick leave is determined individually.

Surgery to remove pterygium with conjunctival plastic surgery using Alloplant: video

Postoperative period: precautions

After the intervention, the patient is given an eye patch, which must be worn until the next day and can be changed as it gets dirty. After its removal, it is necessary to instill medications prescribed by the doctor into the operated eye according to a certain scheme. Anti-inflammatory, antibacterial agents and antimetabolites are prescribed:

The total duration of postoperative therapy is about 30 days.

Do not wet the operated eye for a week. It is recommended to wear glasses with protective ultraviolet filters for two weeks after the intervention. Physical activity is prohibited for the same period.

After surgery, the patient is usually bothered by visual impairment. If the procedure is successful, this function is restored within 5–7 days, sometimes this period lasts a month.

In addition to visual impairment, the patient has corneal syndrome after surgery:

Possible bleeding from the conjunctiva (immediately after surgery), swelling of the operated eye, redness of the eyeball (goes away in 1–2 weeks).

After 7 days, the doctor conducts a follow-up examination; you can begin work 10–14 days after the operation.

After the operation, it is necessary to instill eye drops with medications prescribed by the doctor according to a certain scheme.

In addition to traditional surgery to remove pterygium, doctors use laser treatment. With its help, the head of the pterygoid hymen is cauterized. This method is less traumatic and safer for the patient’s eyes. The recovery period after laser surgery is shorter and there are fewer complications.

Treatment prognosis and complications

The most common complications of progressive pterygium can be:

The following conditions are less common:

Therefore, it is necessary to remove the pterygoid hymen.

Possible complications after surgery:

Long-term complications after the use of cytostatics or radiation therapy may include thinning or ectasia (protrusion of an area) of the cornea or sclera.

Prevention of pathology: how to prevent relapse

Modern techniques make it possible to reduce the frequency of relapses after surgical removal of the pterygoid hymen to a minimum:

General prevention of the disease: