“Recurrent Pterigium?”
Six years ago, in Kenya, I had surgery to remove a Pterigium in my right eye. With time, I have noticed that the area around where the surgery was done is starting to have a growth. It looks slightly different from the Pterigium. I now live in Bali Indonesia where I went for an eye checkup and the doctor pointed out that the growth could be Squamous papilloma or Conjunctival Intraepithelial Neoplasia (CIN). I don't know what these are, but from researching around, I found that CIN is caused by the sun. This is in line with my history of how I developed the Pterigium in the first place. As a child, I used to stare at the midday sun because I thought I could see ghosts of butterflies. Stupid, I know now.
For treatment, the ophthalmologist recommended wide excision surgery together with cryotherapy.
My concern is that the problem might recur again and be much worse in the future. After doing some research, I found Dr. Carol L Karp, from Bascom Palmer Eye Institute, says that a non-surgical solution is possible.
Is my concern grounded and is the non-surgical procedure possible and is it available here in Indonesia?
I have attached the photos of how my eye looks at the moment.
For treatment, the ophthalmologist recommended wide excision surgery together with cryotherapy.
My concern is that the problem might recur again and be much worse in the future. After doing some research, I found Dr. Carol L Karp, from Bascom Palmer Eye Institute, says that a non-surgical solution is possible.
Is my concern grounded and is the non-surgical procedure possible and is it available here in Indonesia?
I have attached the photos of how my eye looks at the moment.
Female | 31 years old
5 Answers
Thank you for your question.
Just from the photo, it is difficult to differentiate this from a recurrent pterigium vs. an additional neoplasticism growth. Treatment for pterigium is generally excision of the lesion and treatment is with cryo and/or a number of chemical or other agents depending on the appearance of the lesion and the experience of the doctor. It may be necessary to do a biopsy to ascertain that it is only a recurrent pterigium. I looked at the Bascom Palmer website and did not find Dr. Karp. At BP is an outstanding Corneal External Disease Specialist, Terrence O’Brien, MD, with whom I am personally familiar. You may want to contact him directly for additional guidance.
Best wishes.
Just from the photo, it is difficult to differentiate this from a recurrent pterigium vs. an additional neoplasticism growth. Treatment for pterigium is generally excision of the lesion and treatment is with cryo and/or a number of chemical or other agents depending on the appearance of the lesion and the experience of the doctor. It may be necessary to do a biopsy to ascertain that it is only a recurrent pterigium. I looked at the Bascom Palmer website and did not find Dr. Karp. At BP is an outstanding Corneal External Disease Specialist, Terrence O’Brien, MD, with whom I am personally familiar. You may want to contact him directly for additional guidance.
Best wishes.
The only way to make a definitive diagnosis is to biopsy the lesion. Pterygium can commonly re-occur but as to whether this is a recurrence or of neoplastic etiology a biopsy is needed.
You definitely need to limit exposing your eyes to the sun by wearing sunglasses with as close to 100% UVA and UVB protection as possible. Also, wear a hat with a brim when outside and exposed to sunlight. You may be able to get DipyEye drops to use a couple of times per day. (The drops are manufactured in Singapore.) In addition, use frequent lubricating drops in both eyes. Certainly, if there is any worsening of the problem, you will need further evaluation. Short-term topical corticosteroid drops under close monitoring by an eye doctor is an option unless this has already been done.
As this could be a precursor for malignant transformation, I would have you consider all your options before simply choosing the most conservative approach.
Best Regards,
David J. Pinhas, M.D.
Best Regards,
David J. Pinhas, M.D.
This looks like a recurant pterygium. This is very common in younger people in the sun. The best treatment is to remove it with a removal of the stem cells of that area of the cornea with a topical treatment of mitomycin-c, followed by an embryonic membrane graft. Reduces recurrent pterygium or con to about 2%.
Dr. LMJ
Dr. LMJ
