Pterygium Classification

Before explaining pinguecula solution, we will explain also about the “close friend”, namely: pterygium. So that later you are not confused anymore when receive an explanation from your doctor about these two terms, namely: pinguecula and pterygium.
The term pingueculitis is a form of inflammation or acute inflammation of pinguecula.

Both pinguecula and pterygium, both are forms of abnormality or degeneration of the conjunctiva (the membrane or a transparent membrane lining the eyeball).

Symptoms:
1. Usually without symptoms (asymptomatic).
2. In many cases a cosmetic problem.
3. Decrease in vision (decreased vision) occurs if the pterygium is close to the axis of eye sight or visual axis.

Signs:
* Pinguecula very common, harmless, usually bilateral (on both eyes).

* Pinguecula usually appear on the bulbar conjunctiva adjacent to nasal limbus (the edge / side of the nose) or temporal limbus. There is a layer of yellow-white (yellow-white deposits), shapeless (amorphous).

* Pterygium is a fold of conjunctiva and tissue fibrovaskular triangular (triangular-shaped fold), which advanced to the surface of the cornea, is almost always preceded by pinguecula.

* Pterygium typically occurs in those who long lived in the climate (temperate) shows the response to heat and drought chronic (long) and exposure to ultraviolet light.

Classification Pterygium:

Type 1: extends less than 2 mm above the cornea. Heap of iron (shown by Stocker line) can be seen in the anterior corneal epithelium / front of the pterygium. Lesion / lesion was asymptomatic, although intermittent can become inflamed (intermittently inflamed). If you wear soft contact lense, symptoms may occur early due to large diameter lens that rests on the tip of the pterygium head slightly up / lift and this can cause irritation.

Type 2: widen to 4 mm of the cornea, can relapse (recurrent), so the need of surgery. Can disrupt the precorneal tear film and cause astigmatism.

Type 3: extending to more than 4 mm and involve areas of vision (visual axis). Lesion / lesion extensive (extensive), if relapse, may be associated with fibrosis subkonjungtiva and extends down to the fornix which sometimes can lead to limitation of eye movement.

Histology:
Pterygium consist of degenerative changes of collagen in the subepithelial stroma.

Cause:
Associated with exposure to sunlight, dust, wind (chronic irritation).

Epidemiology:
Common at age 20-30 years and in areas with tropical climates.

Prevention Pinguecula and Pterygium:
In general, protect the eyes from direct exposure to sunlight, dust and wind, for example by wearing sunglasses.

Solution (Treatment):
Pinguecula
Usually not required medication or special treatment. Except if it is acute inflammation or inflammation called pingueculitis, then given weak steroid, such as: fluorometholone.

Pterygium
Artificial tear drops (artificial tears), mild topical vasocontrictor, or mild topical steroid if there is inflammation. Highly recommended to wear glasses to reduce exposure to ultraviolet.

Pterygium surgery is indicated in type 2 and 3.

Diagnosis (differential diagnosis) Pinguecula and Pterygium:
Some conditions or circumstances that are similar or like both of them include:

1.Conjunctival intraepithelial neoplasia
2.Dermoid
3.Pannus

Complications Pinguecula and Pterygium:

1.Cataract
2.Visual loss
3.Scleral necrosis
4.Persistent epitheliel defect
5.Pingueculitis
6.Dellen formation adjacent to pingueculae
7.Corneal scaring: with pterygium

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