Modern medicine cannot give an unambiguous answer about the initial etiology of the occurrence of pterygium, according to ICD-10 whose code is H11.0. However, ophthalmologists have identified certain factors that can provoke an increase in the pleus on the cornea of the eye.
Causes
Below are the main causes of the occurrence and development of pterygium, and this:
- genetic predisposition;
- regular contact of particles of sand, dust and other irritating and traumatic similar substances on the cornea;
- at risk are also people living in the steppe areas due to regular weathering of the eye mucosa;
- since the inhabitants of the southern regions are most susceptible to pterygium, therefore, the most aggressive factor is exposure to direct sunlight (ultraviolet radiation);
- a long stay in front of a computer monitor, as this leads to excessive dry eyes;
- the presence of inflammatory processes affecting the cornea and eyeball, viral infections such as conjunctivitis can provoke pathological changes in the eye (which can also be exacerbated by the lack of necessary treatment).
It is important to note that the above factors can cause pterygium if they are systematically exposed to the eyes.
Symptoms
The symptoms of pterygium (this is an eye disease) directly depends on the stage of development of the disease and in the early stages does not cause a person any significant inconvenience. Therefore, it is important not to ignore regular medical preventive examinations, because it is during their conduct that the early stages of this pathology are revealed, which is important for positive prognoses when choosing a treatment.
At the initial stage of development of pterygium, the patient can detect the presence of a small cosmetic defect in the form of an opaque formation that barely appears on the edge of the eye, which does not cause pain or serious inconvenience. As the disease progresses, the patient has characteristic symptoms, including:
- the size of the growing hymen on the eyeball increases, which causes a foreign body sensation in the eye;
- decreased peripheral vision, a feeling of clouding in the side of the eye, a feeling of dryness, irritation and redness;
- with a gradual increase in pterygium and as it approaches the center of the cornea, a decrease in vision is observed, since the growth has an opaque consistency;
- if pterygium is accompanied by an inflammatory process, then characteristic signs are observed for this: lacrimation, pain, redness, itching.
Classification
The choice of treatment regimen, as a rule, depends on the variety and stage of the disease. To determine drug therapy in pterygium, an ophthalmologist must take into account the types and forms of development of this pathology, since conservative methods are still acceptable in the initial stages and mild forms, and only surgery will be effective in advanced cases. In medical practice, it is customary to divide pterygium into two types:
- progressive (eventually spreading over the surface of the eyeball);
- stationary (stopped in its growth).
Depending on the degree of development of the disease, there are five stages of pterygium, namely:
- Stage I is considered to be initial, localized on the edge of the eyeball and does not cause a person any inconvenience.
- Stage II occurs when the pterygium reaches the middle of the distance between the edge of the orbit and the pupil with a small percentage of vision loss.
- Stage III is diagnosed when the pterygium reaches the pupil, while visual acuity may deteriorate to 0.5.
- Stage IV is noted in the case of the growth of the pleurium of the pterygium to the center of the pupil with a sharp decrease in vision to 0.2 - 0.3.5.
- Stage V is considered the maximum in area of growth of pterygium, its penetration into the tissues of the eyeball. This stage threatens the patient with almost complete loss of vision, and the operation is fraught with great difficulties.
According to the state of the pterygium episclera, this pathology can be conditionally ranked in the following degrees:
- 1 degree of development of pterygium is characterized by a transparent thin pleural, in which the vessels are clearly visible, this degree, as a rule, is not progressive;
- at 2 degrees, the growth becomes thicker and rises above the eyeball, its structure is translucent;
- grade 3 is characterized by the opaque structure of the pterygium, the vessels are not visible at all.
Diagnostics
Pterygium is a formation that consists of fibrovascular degeneratively altered tissue, it spreads to the central part of the cornea from the conjunctiva. Outwardly, it is a yellowish or whitish muddy influx, with streaks of red or uniform in structure.
Doctors strongly recommend not to wait for compaction and growth of the growth, but as soon as possible to seek advice from an ophthalmologist. With the prolonged development of pterygium, the outgrowth covers more and more surrounding tissues, significantly complicating the treatment process. The following types of studies are usually used to make a diagnosis:
- microscopic analysis using a slit lamp to assess the degree of fusion of the formation with corneal tissue;
- keratotopography - a study of the outer shell of an apple eye with a laser with computer data processing and assessment of visual acuity.
The results of the above examinations will make it possible to detect existing pathological changes in the areas of the iris and sclera, as well as to detect inflammation that adversely affects human vision. If inactive pterygium is small, its removal usually does not bring any negative consequences.
Surgery
There is only one way to treat eye pterygium, and it consists in surgical intervention. Of course, you can use the conservative method with the use of certain drugs, but with its help this disease will not be completely eliminated. You can only slightly alleviate the development of this pathology with the help of drugs and a little stop the disease, but no more.
There is nothing wrong with eye pterygium surgery, and the entire treatment process will take no more than thirty minutes with minimal risk of complications, since surgical manipulation does not require penetration into the eyeball. The entire treatment process is carried out only on the surface of the damaged organ of vision, the surgeon only needs to remove the altered tissue of the conjunctiva. After this, the treated area is simply covered with healthy tissues of the conjunctiva, and they are taken under the upper eyelid. This is necessary not only for aesthetic reasons, but also in order to prevent the re-growth of the conjunctiva.
Healthy pterygium tissue is fixed on the operated area of the eye using special medical glue or using microscopic sutures. Further, the surgeon recommends that the patient only use "Mitomycin", which helps to reduce the risk of re-growth of the tissue after removal of the pterygium (photo pathology is given in the article).
Drug treatment
At the initial stage of pterygium, ophthalmologists prescribe drug treatment, the main purpose of which is to slow down the development of the pathological process and reduce the patient's discomfort. As a rule, medicines are prescribed if the neoplasm is small and slightly impairs a person’s vision.
Means for treatment
As part of drug therapy, an ophthalmologist can prescribe the following types of drugs:
- Moisturizing drops of artificial tears, which reduce the sensation of dryness and burning, characteristic of the growth of fibrovascular tissue on the cornea.
- Anti-inflammatory ointments of the steroid type, which reduce conjunctival irritation, delay the growth of pterygium.
- Antibacterial gels ("Levomycetin", "Tobradex", etc.) that protect the organs of vision and mucous membranes from infection and the development of the inflammatory process.
In addition, medicines can be combined with eye washings with green tea, chamomile infusion, drops based on the leaves of plantain and other folk remedies. They do not contribute to a complete cure, but they can significantly reduce discomfort and remove dryness with irritation.
The effectiveness of drug therapy
As a rule, the use of drugs is relevant in the early stages, but with rapidly progressing pathology or tissue growth to the pupil, the drug effect is not so effective. For this reason, surgery is recommended for complete removal.
Forecast
Today, thanks to the development of ophthalmology, pterygium has a very favorable prognosis:
- if timely diagnostic methods can be used to detect the disease at an early stage, then the problem can be solved conservatively with the help of drug therapy;
- in the advanced case, pathology can be eliminated surgically (both using the traditional instrumental method, and using a laser).
Effects
If treatment of pterygium is not carried out, then the development of this pathology can lead to serious, and sometimes irreversible consequences, including the following:
- irritation of the mucous membrane of the eye, constant sensations of pain and pain;
- decrease in visual acuity, and over time, as tissues grow, and its loss;
- circulatory disorders in the eyeball;
- in rare cases, this neoplasm can develop into a malignant form.
During the appropriate therapy, certain complications may arise, which are usually associated with the stage of the disease treatment. In advanced cases, the corneal tissue completely covers the pupil, and the person loses objective vision. In this condition, it is important to understand that vision will not be restored in full, since during the surgery the pleus is removed, which is fused with the cornea and the transparency of the latter is somewhat lost. In addition, pterygium is saturated with blood vessels, when it is removed, their damage naturally occurs, therefore, after surgery, hemorrhages are observed in the eye, which resolve within a couple of weeks.
Prevention
It should be borne in mind that pterygium belongs to the group of recurrent diseases, so the patient should carefully monitor the appearance of new growths and seek medical help on time. The main preventive measures aimed at preventing pterygium include:
- eye protection from direct sunlight and dust, wind;
- timely treatment of inflammatory processes of the eyes;
- visiting regular preventive examinations by an ophthalmologist.