|Year : 1984 | Volume
| Issue : 5 | Page : 373-377
Quantitative and qualitative estimation of tear in pterygium
DJ Pandey, VK Mishra, YP Singh, Ashok Kumar, DN Pandey
Department of Ophthalmology, S.N Medical College, Agra, India
D J Pandey
Deptt. of Ophthalmology. S.N. Medical College. Agra
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Pandey D J, Mishra V K, Singh Y P, Kumar A, Pandey D N. Quantitative and qualitative estimation of tear in pterygium. Indian J Ophthalmol 1984;32:373-7
Various diverse theeries have been put forward to explain the pathogenesis of pterygia, but actual aetiology is till unexplained. Recently Ultraviolet-Reyerradiation and Microtrauma have been suggested to be the major predisposing environmental factors.
Present study has been conducted to investigate the quantitative and qualitative estimation of tear in Pterigium. in the people ofAgra and its Surrounding.
Geographically Agra is situated at the border of Raj asthan. Agra is hot and dry almost 9 months in the year due to its vicinity to desert climate.
Usual temperature of Agra varies between 35° C to 40° C with exceptions of May and June (40° to 48°C) and Nov..to Jan. (below 35°C). Humidity is least and dry winds are usual feature in at least 9 months of the year.
| Material and method|| |
The present study has been carried out during period Dec. 1980 to Feb. 1983 on 1763 eyes having pterygium of 1400 cases. The control group was taken from the unaffected eyes of the patients and random normal person of either sex and of all age groups from different areas of in and around Agra.
The conventional schirmer's Test and Fluorescein break up time test was carried out in contorl group and persons who were suffering from pterygium.
An intact tear film after 30 second was considered to be normal.
These tests were done when there was no clinical evidence of superimposed infection or other irritation which could predispose to excess tearing.
The observation was plotted in different tabular form.
| Observations and discussion|| |
The present study was carried out on 1763 eyes of 1400 patients. Out of them 929 patients were from various rural areas and 471 patients from O.P.D.. The tendency of prevalence of pterygia in rural area is because of constant exposure of persons to more open and dusty environment in comparison to urban people.
Males were predeminent over females, (males 1051 (75.1%) females 349 (24.9%). It again shows the more exposure of males to external atmosphere than females, suggesive of the environment playing a predominant role in pterygia formation. [Table - 1][Table - 2]
Maximum age group effected is 46=60 and above 60 years. This suggests that the process is progressive in nature but pterygia seen in younger people below 14 years is only two (2) out of 1051 male cases which is statistically insignificant.
The schirmirs test carried out in control group of unilateral pterygia in males was 13.44 mean value while standard deviation in the group was 1.36. The females were having higher tendency mean as well as standard deviation value of schirmers test, 17.22 and 2.40 respectively.
This indicates that females are having more schirmers value as compared to males, which was also noticed by earlier workers.
The mean and standard deviations in normal male and female group of control is having lesser secretion in males as compared to females. (Males 13.48 SD-1.23, Females 17.01 SD-1.97).
The schirmers test observed on effected (unilateral and bilateral pterygia) eyes of either sex was less than 11 mm with mean value 8.95, 10.59, 9.70, 10.21 and standard deviation was 1.84, 1.79, 2.04 and 2.07 respectively.
The `T and `P' values were recorded in males v/s males unilateral, femals v/s female unilateral, males v/s male prilateral, female v/s female bilateral i.e. 57.028, 30.828, 17.026 and 25.031 with standard `P' value less than 0.001.
These values were also recorded in males of unilateral v/s bilateral, females of unilateral v/s females of bilateral, male v/s female in unilateral and male v/s female in bilateral and the values were 9.828, 0.9371, 10.772, 2.168.
These values provide clear indication that quantitattive tear estimation by conventional schirmers test method was lesser in pterygia effected eyes in either sex than the normal control group. Where t values have statistical significance.
Of the 1783 eyes with pterigium 461 showed normal tear film and 1322 showed some abnormality, whereas in 1383 control eyes 368 were normal and 1015 abnormal.
`T' and `P' value were recorded in males v/s males (Unilateral) females v/s female unilateral, males v/s male bilateral, female v/s female bilateral i.e. .524,1.83,.83 and .92 with standard `P' value less than 0.001.
these values were also recorded in males of unilateral v/s bilateral, females of unilateral v/s females of bilateral, male v/s female in unilateral and male v/s female in bilateral and the value were 0.82, 0.9371, 1.62 and 1.84. These result were analysed statistically and the difference was shown to be of no significance.
The finding of so many `abnormal' results in fluorescein break up time test in trial groups and controls in spite of the fact that in none was there any symptom that could be related to dry eye, emphasized the present inadequacy of this test. This study still need further evaluation.
Our study using this test supports the hypothesis of Paton who supports the primary tear film abnormality predisposing to pterygia formation.
This study contradicts the study done by Goldergetrl on 59 eyes who found no correlation between dry eye and pterygia.
| Summary|| |
The conventional schirmers test was conducted on 1783 eyes of pterygia of different age and sex group and it was found that the tear formation was less in the patients with pterygia but this study showed no significant difference in the quality of the tear film (from fluorescien break up time) in the trial group and controls.
| References|| |
Cameron, M.N., 1962. Trans. Ophthalmol., Soc. Aug., 20:1967.
Barraquer, J.I., 1965. Ophthalmologica (Bassel), 151:111.
Paton, D., 1965. Trans. Amer. Acad. OphthalmoL, Oto. Larying 79:603.
Goldberg L. and David, R 1976. Bret. J. Ophthalmol., 60:720.
[Table - 1], [Table - 2], [Table - 3], [Table - 4], [Table - 5], [Table - 6], [Table - 7], [Table - 8]
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