PTERYGIUM. ITS NATURE AND A NEW LINE OF TREATMENT

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Abstract
A chronic irritative exposure conjunctivitis has been shown on histological and clinical grounds to be the potential precursor of pterygium. A true pterygium, however, only occurs when, in addition, corneal changes are present. Thus the fully developed preliminary stage is a chronic kerato-conjunctivitis. The condition is primarily an inflammation, and extension of the inflammatory process is by continuity and contiguity. The degenerative changes which occur are secondary and post-inflammatory in nature. Histologically, there is a marked similarity between early and late pterygia except that in the latter the elastic-like degenerated fibres in the deeper parts of the section appear shrunken and contracted. It is this shrinkage which pulls the conjunctiva on to the cornea, and the encroachment of the conjunctiva is in direct proportion to the intensity of the inflammation. The contraction of the submucous connective tissue fibres also causes diminution of the blood supply and makes a pterygium a self-limiting pathological condition. Pterygium is an irritative disease but there is no one etiologic factor. Constant exposure to sandy dust is a common cause and this gives a high disease incidence in certain localities.
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