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There is a mass growing over the front of my eye (Pterygium). What do I do now?

A large pterygium extending over the front of the eye.

1.I have been diagnosed with a pterygium. Can you tell me more about this? 

Pterygium is a triangular extension of the transparent layer of the eye over the white part of your eye called conjunctiva. This can be in one or both eyes and is usually on the nasal side.

The cause of this is not known but it is seen in people who are exposed to bright sunlight and UV light. It is also shown to have a genetic predisposition.

2.Do I need a Pterygium surgery?

A pterygium should be removed if it is

1) large

2) covering the pupil 

3) causing very high cylinder number

4) causing irritation

5) for cosmesis.

3.How is Pterygium Surgery done?

Pterygium is surgically removed and a part of the conjunctiva from your same eye is used to cover the area to prevent recurrence. This conjunctiva is fixed in place using several methods such as a special glue for the eye or sutures. 

It is an extraocular surgery and oftentimes is not risky or complicated.

An injection will be given next to your eye to numb it, it is a painless procedure.

It is a day care procedure and you will be discharged on the same day.

After surgery you may feel some amount of watering, redness, irritation in the eye for a few days.

A small faint opacity may be left behind where your pterygium was if it was very deeply seated.

Your eye will be patched for 4-6 hours or overnight after surgery.

4.Can my pterygium come back after surgery?

Pterygium surgery with conjunctival autograft reduces the chance of recurrence significantly. Recurrence can rates are less than 5% safe.

5.Are there any restrictions after pterygium surgery?

The usual! You have to avoid rubbing your eye. Avoid exposure to dust or dirty water into the eye for a week after surgery.

6.What if I delay my Pterygium surgery?

Delay in pterygium can allow it to grow deeper as well as towards the center of cornea. In such cases, despite surgery some residual scar tissue is left behind.

7.What is limbal dermoid?

Limbal dermoid is a benign congenital tumor involving the outer coat of the eye. More than 2/3rd of dermoids occur at the inferotemporal bulbar location of the eye.

8.What is Goldenhar’s Syndrome (Oculo-Auriculo-Vertebral Syndrome) ?

Goldenhar’s Syndrome comprises of Preauricular fistula, Preauricular appendages, epibulbar dermoids of lipodermoids and mandibular hypoplasia.

9.What is the management of Limbal Dermoid ?

Medical management is generally reserved for grade-I dermoid which are smaller lesions in terms of diameter and height inducing only mild astigmatism (<1D). Routine follow-up with spectacle correction and amblyopia treatment is required.

Development of clinically significant anisometropia, lack of compliance with follow-up / amblyopia treatment, growth of dermoid causing dellen formation and esthetic considerations – if any or combination of above condition is noted, surgery should be considered.

10.What should be the ideal age of surgery?

Appropriate timing of excision of dermoid is a topic of debate. Optimal timing of surgical intervention depend on multiple factors including the original size of the lesion, rate of its growth, secondary corneal defect/ dellen, anatomical area involved, secondary corneal growth as well as psychosocial factors.

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