Modern medicine cannot give an unambiguous answer about the initial etiology of the occurrence of pterygium, according to the ICD-10 code of which is H11.0. However, ophthalmologists have identified certain factors that can provoke the growth of the hymen on the cornea of the eye.
Reasons
The following are the main causes of the occurrence and development of pterygium, and these are:
- genetic predisposition;
- regular exposure to the cornea of particles of sand, dust and other irritating and traumatic similar substances;
- at risk are also people living in the steppe regions due to regular weathering of the mucous membrane of the eye;
- since residents of the southern regions are most susceptible to pterygium, therefore, the most aggressive factor is exposure to direct sunlight (ultraviolet);
- long stay in front of the computer monitor, as this leads to excessive dryness of the eyes;
- the presence of inflammatory processes affecting the cornea and eyeball, viral infections such as conjunctivitis canprovoke pathological changes in the eye (which, moreover, may be aggravated 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 eye.
Symptoms
The symptoms of pterygium (this is an eye disease) directly depend on the stage of development of the disease and in the early stages does not cause any significant inconvenience to a person. 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 detected, which is important for positive prognosis when choosing a treatment.
At the initial stage of development of pterygium, the patient may find that he has a small cosmetic defect in the form of an opaque formation barely showing at the edge of the eye, which does not cause pain or serious inconvenience. As the disease progresses, the patient develops characteristic symptoms, including:
- the size of the growing hymen on the eyeball increases, which causes a sensation of a foreign body in the eye;
- decreased peripheral vision, cloudy feeling in the side of the eye, 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 characteristicsigns: tearing, pain, redness, itching.
Classification
The choice of treatment regimen, as a rule, depends on the type and stage of the disease. To determine drug therapy for 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 surgical intervention will be effective in advanced cases. In medical practice, it is customary to divide pterygium into two types:
- progressive (over time spreading over the surface of the eyeball);
- stationary (stopped in growth).
Depending on the degree of development of the disease, there are five stages of pterygium, namely:
- I stage is considered initial, localized on the edge of the eyeball and does not cause any inconvenience to a person.
- II stage occurs when the pterygium has reached 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, and visual acuity may deteriorate to 0.5.
- IV stage is noted in case of growth of the pterygium hymen to the center of the pupil with a sharp decrease in vision to 0, 2 - 0, 3.5.
- V stage is considered the maximum in terms of the area of pterygium growth, its penetration into the tissues of the eyeball. This stage threatens the patient with almost complete loss of vision, andthe operation is very difficult.
According to the condition of the pterygium episclera, this pathology can be conditionally ranked according to the following degrees:
- 1 degree of development of pterygium is characterized by a transparent thin hymen, in which the vessels are clearly visible, this degree, as a rule, is not progressive;
- at grade 2, the growth becomes thicker and rises above the eyeball, its structure is translucent;
- 3 degree is characterized by an opaque structure of the pterygium, while the vessels are not visible at all.
Diagnosis
Pterygium is a formation that consists of fibrovascular degenerative tissue, it extends to the central part of the cornea from the conjunctiva. Outwardly, it is a yellowish or whitish cloudy influx, with red streaks or uniform in structure.
Doctors strongly recommend not to wait for thickening and growth of the build-up, but to seek advice from an ophthalmologist as soon as possible. With the long-term development of pterygium, the growth 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 - examination of the outer shell of the apple of the eye with a laser with computer data processing and assessment of visual acuity.
The results of the aboveexaminations will make it possible to detect existing pathological changes in the areas of the iris and sclera, as well as detect inflammation that negatively affects human vision. If the inactive pterygium is small, removing it usually does not bring any negative consequences.
Surgical treatment
There is only one way to treat pterygium of the eye, and it consists in surgical intervention. Of course, you can use a conservative method with the use of certain drugs, but with its help it will not be possible to completely eliminate this disease. One can only slightly alleviate the development of this pathology with the help of drugs and stop the disease a little, but nothing more.
There is nothing wrong with pterygium eye surgery, and the entire treatment process will take no more than thirty minutes with a minimal risk of complications, since the 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 conjunctival tissue. After that, the treated area is simply covered with he althy tissues of the conjunctiva, and they are taken under the upper eyelid. This is necessary not only for aesthetic reasons, but also to prevent the re-growth of the conjunctiva.
He althy pterygium tissue is fixed on the operated area of the eye with a special medical adhesive or with microscopic sutures. Further, the surgeon recommendsthe patient can only use Mitomycin, which helps reduce the risk of re-growth of tissue after removal of the pterygium (a photo of the pathology is given in the article).
Medicated 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 patient discomfort. As a rule, drugs are prescribed if the neoplasm is small and slightly impairs a person's vision.
Medications
As part of drug therapy, the ophthalmologist may prescribe the following types of drugs:
- Moisturizing drops of artificial tears that reduce the sensation of dryness and burning, characteristic of the growth of fibrovascular tissue on the cornea.
- Anti-inflammatory steroid-type ointments that reduce conjunctival irritation and inhibit pterygium growth.
- Antibacterial gels ("Levomycetin", "Tobradex", etc.), protecting the organs of vision and mucous membranes from infection and the development of the inflammatory process.
In addition, medicines can be combined with eyewash with green tea, chamomile infusion, drops based on plantain leaves and other folk remedies. They do not contribute to a complete cure, but they can significantly reduce discomfort and remove dryness with irritation.
Effectiveness of drug therapy
As a rule, the use of drugs is relevant in the early stages, but whenrapidly progressing pathology or tissue growth to the pupil, the drug effect is no longer 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 detect the disease at an early stage, then the problem can be solved conservatively with the help of drug therapy;
- in an advanced case, the pathology can be eliminated surgically (both using the traditional instrumental method and with the help of a laser).
Consequences
If pterygium is not treated, the development of this pathology can lead to severe and sometimes irreversible consequences, including the following:
- irritation of the mucous membrane of the eye, constant sensations of cutting and pain;
- decrease in visual acuity, and over time, as tissues grow, and its loss;
- poor circulation in the eyeball;
- in rare cases, this neoplasm can develop into a malignant form.
During appropriate therapy, certain complications may occur, which, as a rule, are associated with the stage of the disease at which treatment was started. 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 full vision is notwill recover, because during the surgical intervention, the hymen is removed, which is fused with the cornea and the transparency of the latter is somewhat lost. In addition, the pterygium is saturated with blood vessels, when it is removed, their damage naturally occurs, therefore, after surgery, hemorrhages are noted 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 in time. The main preventive measures aimed at preventing pterygium include:
- eye protection from direct sunlight and dust, wind;
- timely treatment of inflammatory processes in the eyes;
- attending regular check-ups with an ophthalmologist.
