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Childhood pterygium: a descriptive study of 19 cases presented to a tertiary eye care center
Sumit Monga1, Amit Gupta, Ramesh Kekunnaya
1Jasti V Ramanamma Children's Eye Care Centre, KAR Campus, L.V. Prasad Eye Institute, Hyderabad, India.
Insights
Childhood pterygium can occur in young patients, with no clear environmental or familial links identified. Most cases of this eye condition resolve with conservative management, though surgery is sometimes needed.
Area of Science:
- Ophthalmology
- Pediatric Ophthalmology
Background:
- Pterygium, a wing-shaped fibrovascular growth on the eye's surface, typically affects adults.
- Limited data exists on the presentation and management of pterygium in pediatric populations.
Purpose of the Study:
- To characterize the demographics, clinical presentation, and management strategies for childhood pterygium.
- To identify any predisposing factors associated with pterygium in children.
Main Methods:
- Retrospective case series of 19 children (26 eyes) under 16 years old diagnosed with pterygium.
- Data collected included clinical features, associated conditions, management approaches, and histopathology of surgical cases.
Main Results:
- The mean age of presentation was 10.6 years; 37% had bilateral involvement.
- No familial or specific environmental risk factors were identified.
- 85% of cases were managed conservatively; 15% required surgery (pterygium excision with conjunctival-limbal autograft).
- One surgical case recurred after 1 year.
Conclusions:
- Pterygium can develop in children, even without identifiable risk factors.
- Conservative management is effective for the majority of childhood pterygium cases.
- Surgical intervention may be necessary for some, with a low recurrence rate observed.
Purpose:
To describe the demographic features, clinical characteristics, and management in cases of childhood pterygium.
Design:
Observational case series.
Methods:
A retrospective review was done of 19 children (total 26 eyes) under the age of 16 years, consecutively presenting with pterygium and evaluated at a single tertiary care center between January 2000 and August 2011. The main outcome measures were clinical features, associated ocular or systemic diseases, approach towards its management, and histopathology of operated cases.
Results:
Of the 19 patients, 10 were girls and 9 were boys. The mean age at presentation was 10.63 ± 3.48 years (range 2-15 years). Seven patients (37%) had bilateral involvement. None of the cases had familial history. The median refractive astigmatism was found to be -0.5 diopter cylinder. All the eyes had primary pterygium, except 1, which was recurrent. The majority of the eyes (85%) were managed conservatively. Four eyes (15%) required surgery, where pterygium excision with conjunctival-limbal autograft with fibrin glue application was done. The follow-up of surgical cases ranged from 5 to 38 months (median 6 months). One operated case recurred 1 year after surgery.
Conclusion:
Development of pterygium is a possibility in younger age groups. No specific predisposing factors, either environmental or familial, were identified as contributing to childhood pterygium. The majority of the cases required conservative management.
