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Pterygium, carnosidad, conjunctival autograft, conjunctiva - A State of Sight #10

Isaac Porter, MD from Lowry Porter Ophthalmology explains the basics of corneal transplantation, which is one of the most successful transplants in humans. Patients with cloudy, hazy, swollen, or scarred corneas may benefit from a transplant. Modern surgical techniques now allow the replacement of the entire cornea or selective transplantation of the inner or outer layers.




Welcome to A State of Sight, I’m Isaac Porter from Lowry Porter Ophthalmology and we continue to bring you the latest in ophthalmology and eye care from Raleigh, NC. In the past week, I had a patient with a pterygium and I thought it would be a great time to bring you the details about what a pterygium is and how it can be treated.
 
First, to understand pterygium let’s review the eye anatomy. The conjunctiva is the thin skin that covers the surface of the eye, it’s not shown on this eye model since you can see the eye muscles that lie underneath the conjunctiva. When we look at the white of someone’s eye it’s covered by this thin skin.
 
Usually, due to UV light exposure, or possibly from dryness or irritation, the conjunctiva can become inflamed and start to grow over the clear cornea. This can interfere with vision, and this is a pterygium.
 
The word, pterygium, comes from a Greek word that means “wing” because the pterygium is usually shaped like a wing on the eye. This is the same word that also gave rise to the word pterodactyl, which is, as you may recall, the dinosaur with wings. Our Hispanic patients call a pterygium carnosidad.
 
This can cause many problems, most commonly irritation of the eye and redness. However, if it becomes large it can grow over the center of the cornea and interfere with vision. Also, it can become large and elevated, causing astigmatism which can affect vision.
 
Fortunately, there are many solutions for pterygium. The most straightforward one is to use extra artificial tears for lubrication on the eye to make it more comfortable. However, many times when it becomes larger it requires surgery to remove the pterygium.
 
This can be done several different ways, but the way I prefer to remove it involves taking a conjunctival autograft, or a piece of healthy conjunctiva, from the top of the eye. This is then moved down and glued into place where the pterygium was removed from to help prevent recurrence of the pterygium. Regrowth of the pterygium is one of the most common problems with many types of procedures that are used to remove a pterygium.

If you have any other questions about pterygium or you would like to know more please post below, we will be happy to interact with you. I hope you are doing well until we see you again, next time on A State of Sight.