Pterygium

For 2 years, a 66-year-old woman had a winglike structure on the nasal side of her right eye. She had normal vision. A diagnosis of pterygium was made. This fleshy, raised, triangular thickening of the bulbar conjunctiva extends onto the cornea, unlike a pinguecula, which affects only the conjunctiva. Pterygium is from the Greek word for “wing.”

It results from the degeneration of normal subconjunctival tissue and its subsequent proliferation as vascular granulation tissue. The condition is more prevalent in older persons, especially those living in areas with sunny and windy climates. In long-standing cases, the pterygium may encroach onto the pupil and impair vision. In these cases, surgical removal of the pterygium is required.

Otherwise, the pterygium can be left alone. This patient was reassured of the benign nature of the lesion. She was advised to wear sunglasses that provide ultraviolet protection and to use artificial tear lubrication to prevent further progression.