Pterygium, or “atrophic ectopia conjunctiva,” is a disease characterized by progressive proliferation of the vascular conjunctiva, which may extend to the cornea of the eye. This pathology in most cases begins in the area of the inner corner of the eye and has the appearance of a triangular thickening. Pterygium is often associated with prolonged exposure to ultraviolet radiation and extreme climatic conditions. The main symptoms include redness, irritation, dryness, and the effect of “sand in the eyes,” but in advanced cases the disease can lead to deterioration of vision if the proliferation affects the central zone of the cornea. Unfortunately, relapses after surgical treatment are quite common, which makes pterygium a relevant topic for research and discussion in ophthalmology.
History of the disease and interesting historical facts
Pterygium has been known to mankind for many centuries. The first mentions of the disease can be found in ancient Greek and Roman medical texts, which indicates its prevalence in ancient times. For the first time, as a name for the disease, pterygium was described by Hippocrates, who described in detail its symptoms and consequences. Later, in the Middle Ages, significant steps were made in the field of diagnostics and treatment of this disease. In the 20th century, with the development of ophthalmology and improvement of surgical techniques, more effective methods of radical treatment appeared, but high rates of relapse remain relevant to this day. In recent decades, research has intensified on the molecular and genetic aspects of the disease, which opens new horizons for understanding its etiology and pathogenesis.
Epidemiology (statistics of disease occurrence)
Pterygium is a common condition, especially in geographic areas with high levels of solar radiation. According to epidemiological studies, the prevalence of pterygium in adults in sunny areas can range from 2 to 40%. The risk of developing pterygium increases with age, with the highest incidence observed in patients aged 20-50 years. According to the WHO, the disease is more common in men, which may be due to their greater likelihood of long-term outdoor exposure, including sun exposure or working in bright sunlight.
Genetic predisposition to this disease
It has now been established that genetic predisposition can play a significant role in the development of pterygium. The most relevant are genes involved in the metabolism of growth factors and inflammatory processes. Modern research shows that mutations in genes that control the synthesis of collagen and other structural proteins can increase the likelihood of developing pterygium. In addition, changes in DNA associated with the body's response to ultraviolet radiation can also be the cause of predisposition to this disease.
Risk factors for the development of this disease
There are several known risk factors that contribute to the development of pterygium. These include:
- Long periods of exposure to the sun without protection (for example, without protective glasses).
- Working outdoors in sunny and dusty conditions.
- The presence of white eyes (especially in people with low levels of melanin).
- Age: The risk increases with age.
- Genetic predisposition in the family (presence of cases of pterygium in close relatives).
- Infectious processes that can lead to conjunctivitis.
- History of serious allergic reactions.
Diagnosis of this disease
Diagnosis of pterygium is based on clinical examination and patient interview. The main symptoms to consider are:
- Redness in the eye area.
- Discomfort and dryness.
- Visual impairment with progression.
Laboratory tests may include tests to detect allergies or infections, but they are not necessary to diagnose pterygium. Radiological methods, such as ultrasound, are rarely used. The main diagnostic method is biomicroscopy, which allows for a visual assessment of the conjunctival proliferation. It is also necessary to conduct a differential diagnosis with other eye diseases, such as fibroma, which can manifest similar symptoms.
Treatment
Treatment of pterygium can be conservative or surgical. Conservative methods include the use of artificial tears, antihistamines, and anti-inflammatory ointments. These methods are aimed at relieving symptoms and slowing the progression of the disease. Surgical treatment is usually performed when symptoms are severe or there is a risk of vision loss. The operation involves excision of the pterygium followed by conjunctival transplantation. In recent years, there has been an increase in the use of adjuvant therapy, including the use of antimetabolites to reduce the risk of relapse.
List of medications used to treat this disease
- Artificial tears (eg, Systane, Taufon).
- Anti-inflammatory ointments (for example, Diclofenac).
- Antihistamines (eg, Loratadine, Cetirizine).
- Immunosuppressants (eg, Mycomesin).
- Surgical drugs (for example, "Levomycetin" for treatment after surgery).
Disease monitoring
After pterygium treatment, regular monitoring of the patient's condition is important. Control stages include scheduled visits to the ophthalmologist, where the eye condition, relapses and other complications are assessed. The prognosis is favorable if treatment was started in a timely manner, but relapses occur in 20-30% cases during the first 2 years after surgery. Complications may include re-growth, infectious processes and the development of keratitis.
Age-related features of the disease
Pterygium is extremely rare in people under 20 years of age. The highest incidence rate is observed in people over 30 years of age. In older people, the disease often takes a more aggressive form, which is associated with degenerative processes in the eye tissues and immunological changes. In children, it is considered rare and may be associated with exposure to ultraviolet radiation in combination with a hereditary predisposition.
Questions and Answers
- What is pterygium? Pterygium is a condition characterized by the growth of conjunctiva on the cornea, which can lead to visual impairment.
- What are the main symptoms of pterygium? Symptoms include redness, dry eyes, discomfort and decreased vision if it progresses.
- How is pterygium treated? Treatment can be conservative with the use of eye drops and ointments or surgical removal of the growth.
- What is the risk of recurrence after surgery? The risk of recurrence ranges from 20 to 30% during the first two years after surgery.
- What factors contribute to the development of pterygium? Important factors include long-term exposure to sunlight, age, genetic predisposition and outdoor work.
