There are two types of collagen corneal crosslinking- Epithelium-off and epithelium-on corneal crosslinking. Epithelium-off cross linking involves removing the topmost layer of the cornea, the epithelium to allow better penetration of the riboflavin drops. On the other hand, Epithelium-on corneal crosslinking involves leaving the epithelial layer intact during the application of riboflavin. This treatment process is less invasive than epithelium-off and is also called transepithelial crosslinking. But there are other treatment methods like Accelerated corneal crosslinking using UV radiation at an increased rate or contact lens-assisted corneal crosslinking using an ultraviolet barrier-free contact lens soaked with riboflavin for the effects.
A pterygium is abnormal thickening and growth of the tissue (conjunctiva) overlying the white part of the eye (sclera), and extension of this growth onto the cornea.
It is most commonly found on the side of the eye adjacent to the nose, and is often noticed as a redness that is gradually increasing in size.
Though the exact reason is not known, it is postulated by researchers and scientists that pterygium occurs due to hyperplasticity or excess growth of the limbal epithelial cells along with vascularization or formation of blood vessels over it that gives it its pink appearance.
Healthy conjunctiva and cornea are characterized by a normal limbal area in the cornea and the conjunctiva border. The limbus also contains barrier stem cells that prevent the conjunctival epithelial cells from migrating to the corneal surface. But factors like age, the effect of the sun, especially U.V. radiation, warm or dusty weather conditions, along with a genetic deficiency of these stem cells can cause the barrier to weaken or dissolve. This will lead to the encroachment of the conjunctival cells over the cornea called the pterygium.
Diagnosis of the Pterygium
Before you look for pterygium treatment in London, it is important to first arrive at a conclusive diagnosis about the pterygium. A thorough slit lamp examination can make a diagnosis of the pterygium to check the cornea, conjunctiva, and limbus through a microscope. Fluorescent staining of the eyes and Shimer’s Tests are done at this point as a part of the diagnostic procedures. The aim is to check the level of irregularities and dryness caused due to the pterygium.
During this period, a visual acuity test is done to check the possibilities of astigmatism caused by the invasion of the fleshy pterygium over the corneal surface. If required, Corneal Topography and an occasional biopsy can also be advised by the surgeon to see the status of the cornea along with ruling out cancerous lesions before the surgery. The eyes are photographed as a part of the diagnostic procedure to check the improvement post-surgery.
Phases of Pterygium Treatment
Do you need surgery?
Can you prevent it?
Unfortunately, pterygium formation’s exact mechanism is not known because preventing it from occurring is not a feasible option. But maintaining a healthy eye from the start can prevent the chances of pterygium formation to a great extent. Maintaining a balanced diet and drinking sufficient water can ensure the health of your eyes to a great extent. Sincerely wearing protective eyewear outside of the house can reduce the occurrence chances of the pterygium and halting its progress if it has already started. But most importantly, regular eye check-ups can give a clear idea to the surgeon about the progression of the tissue. This will help him excise it at the right moment with minimal corneal scarring and optimum vision recovery post-surgery.
Taking care of the risk factors
Sun, radiation effects, U.V. radiation, pollen, and genetic factors are the most important risk factors for Pterygium formation. Wearing good-quality sunglasses can minimize the risk of sun damage to a great extent.
Avoiding the radiation causing agent or full face protection can take care of the radiation factors leading to the formation of radiation. Prolonged use of computers can cause the computer system-induced U.V. radiation to cause dryness, thus further increasing the pterygium discomfort.
Using an anti-reflection coating while sitting in front of the computer for prolonged periods can take care of the issue. Pollen can lead to allergic reactions causing itching, which can increase inflammation. Using antihistamines along with avoiding the source of allergies can sort these particular risk factors. We don’t have any control over the genetic factors. But a regular check-up can make the symptoms known from an early period which can help in better treatment of the problem. You can get in touch
Frequent asked questions (FAQs):
Often a pterygium will not require treatment. Intermittent irritation and redness is often successfully treated with lubricating eye drops (artificial tears).
Occasionally, a short course of steroid eye drops is used if there is significant inflammation.
Surgery is an option when the pterygium interferes with vision, causes persistent inflammation or is making the eye appear abnormal.
Surgery is most frequently performed under local anaesthesia, but can be performed under sedation or general anaesthesia. The eye is usually sore and red after the surgery. Using the drops prescribed by your doctor after surgery is important to minimise risk of infection and inflammation.
A pterygium can recur after surgical removal. However, modern techniques in pterygium surgery have significantly reduced the recurrence rate from almost 90% down to about 5-10%.
The rate of recurrence is influenced by several factors. For example, it is much higher when removing a recurrent pterygium (one which was operated on before), or in certain ethnic groups (e.g. Hispanics).