|Year : 1982 | Volume
| Issue : 1 | Page : 61-62
A rare complication of pterygium
Chakko Puthenpurayil Thommy
Senior Consultant Guinness Ophthalmic Unit Ahmadu Bello University Hospital P. M.B. 2016 Kaduna, Nigeria
Chakko Puthenpurayil Thommy
Senior Consultant Guinness Ophthalmic Unit Ahmadu Bello University Hospital P.M.B. 2016 Kaduna
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Thommy CP. A rare complication of pterygium. Indian J Ophthalmol 1982;30:61-2
Apart from causing local corneal ulceration, no reactions seems to occur from insects, However, Duke-Elder considers body fluids of insects can cause superficial reactions on the cornea and conjunctiva as well as the lids.
In the case reported here, the insect caused a corneal ulcer, infiltration involving all the layers of the cornea, and a uveal reaction lodging itself in the shelf formed by upper fold of pterygium.
| Case report|| |
A 45 year-old male (D.J.) was diagonsed as a medial pterygium in the left eye. He was posted for pterygium excision two weeks later. The day before surgery it was noticed that the pterygium was congested as was also the adjacent conjunctiva. There was also a ciliary flush in a sector shaped manner between the pterygium and the 12 O'clock position. On slit lamp examination, a dark brown insect could be made out in the shelf formed by ; the upper fold of the pterygium at the corneal end. The insect was removed. The site occupied by the insect had become a staining corneal ulcer. Moreover, there was a corneal infiltration involving all the layers spreading in-wards. Descemet's folds could be seen radiating from the ulcer area. There were a few keratic precipitates on the endothelium where the corneal infiltration was. A moderate acqueous flare was present. The ulcer healed promptly on usual treatment leaving a facet or pit which was gradually invaded by blood vessels in a month's time. As the ulcer started healing, a subconjunctival injection of depot steroid was given and a short course of systemic steroid instituted to control the inflammation which was otherwise not subsiding. After the inflammation subsided, the infiltrated area was opaque involving all layers. The pterygium was excised and beta irradiated after 2 months. The post operative period was uneventful. [Figure - 1].
| Discussion|| |
This rare incidence of an insect getting lodged in the upper fold of a pterygium would indicate another area to be searched for a foreign body similar to the superior tarsal sulcus. Indeed the upper fold of a large growing pterygium forms a considerable potential space for a foreign body to get lodged. An insect because of its secretions can set up a reaction in the conjunctiva, the cornea and the endothelium and the Iris. Serious visual impairment may result if the condition is not recognised early and treatment instituted.
| Summary|| |
An insect getting lodged in the shelf formed by the upper fold of a pterygium has not been reported. This case illustrates the possibility of such an occurrence. It caused a corneal ulcer, infiltration involving all layers of the cornea, and a uveal reaction.
| References|| |
Grant, W.M., 1979, In Toxicology of the eye 2nd ed. Illinois Charles C. Thomas p. 579.
Zauberman, H., and Neumann, E, 1965, Amer. J. Ophthalmol. 60 :467.
Duke-Elder, S., And MacFaul, P.A, 1972, Injuries, In System of Ophthalmology Vol. XIV Part 2, London Henry Kimpton p. 1346.
[Figure - 1]