|Year : 1977 | Volume
| Issue : 1 | Page : 37-38
Cystic degeneration of the pterygium
Shashi Kapoor, GC Sood, AL Aurora, Manorma S Kapoor
Department of Ophthalmology, Jawaharlal Institute of Post-Graduate Medical Education and Research, Pondieherry-6, India
Department of Ophthalmology, J.I.P.M.E.R., Pondicherry-6
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Kapoor S, Sood G C, Aurora A L, Kapoor MS. Cystic degeneration of the pterygium. Indian J Ophthalmol 1977;25:37-8
Pterygiurn is a degenerative condition which presents as a fleshy growth on the nasal side of bulbar conjunctiva. Pathologically it is a proliferation of the subconjunctival tissues as vascularized granulation which has a tendency to invade the cornea .  It runs, usually  a benign course; sometimes its epithelium can undergo a malignant transformation  and its stroma a cystic change. ,
The object of the present communication is to report two cases of pterygium with cystic degneration and discuss their pathogenesis.
| Case Reports|| |
A 35-year-old man presented with a horizontally oval cystic swelling measuring 8 x 3 mm in the body of the nasal pterygium in left eye [Figure - 1]. The cyst was there for the last 6 months and was stationary in its size. The cyst could be moved freely and was free from the the deeper structures. The pterygium was pale and no blood vessel could be seen on the cyst. The swelling was painless and nontender. There was no history of any prior inflammatory episode in this eye. The ocular movements were normal and the preauricular lymph nodes were not palpable.
The whole of the pterygium was excised; a part of the sclera was left bare and the cornea was cauterized. The mass was subjected to histopathological examinanation. Microsocopic examination revealed a cyst lined with stratified squamous epithelium in the stroma of the pterygium. The cyst had lot of cellular debris in it and a mild inflammatory reaction was surrounding the cyst all-round [Figure - 2].
A 45-year-old man presented with a swelling on the temporal limbus of the left eye for 4 months. An examination of the left eye showed a globular cyst measuring 1 x I x 0.6 cm in the body of a thin, avascular, and atrophic temporal pterygium. The cyst was free from the deeper structures; it could be moved in the vertical direction. The ocular mobility was normal. The history of any inflammatory attack in this eye was lacking [Figure - 3].
| Discussion|| |
The conjunctival cysts can be of various varieties  , i.e., epithelial implantation, parasitic, glandular retention and lymphatic. The cysts in the pterygium are believed to follow an inflammatory reaction  in the stroma of the pterygium which result in down-growth of the surface cylindrical cells, the central core of which undergoes a degenerative change to form cystic cavities. The cysts can be unilocular or multilocular depending upon the number of places the down-growing cells undergo degeneration. Also. the cysts can be congenital in origin when they are deep to the pterygium and fixed to the deeper structures  .
The free mobility and non-adherence of the cysts to the deeper structures are suggestive of the acquired origin of cysts in our cases.. A mild reaction in the pterygium, in the absence of an inflammatory episode, is an insufficient proof of the inflammatory origin of the cysts. The inflammatory reaction in the pterygium can result from the pressure effect of the cellular debris in the cysts, though a mild inflammatory reaction in the pterygiurn is considered. Normal  . The intact epithelial lining of the pterygium is another proof against the inflammatory origin, where the lining is expected to be disorganized. The cysts, thus appear to be the result of cellular down-growth following primary degeneratsive changes in the stroma of the pterygium rather than an inflammatory episode, as is conjectured.
| Summary|| |
Two cases of pterygium with cystic degeneration are described. The inflammatory hypothesis of their origin is refuted and primary degenerative phenomenon is held responsible for the cystic changes in the pterygium.
| References|| |
Bistic, J., 1921, Arch. Ophthal. (Paris),
Boniuk, M., 1970, Survey Ophthal.,
Duke-Elder, S, and Leigh, A.G., 1965, Sys. Of Ophtha,
Kamel, S., 1955, Bull. Ophthal.Soc.
Mathur, S. P., 1959, Brit. J., Ophthal.,
[Figure - 1], [Figure - 2], [Figure - 3], [Figure - 4]