Anil Kumar Gupta, Isha Gupta and Renu Rathore
Pterygium, recurrent pterygium, and pyogenic granuloma share similar etiologic factors and overlapping clinical and histopathological features, may result in impaired vision, induced astigmatism, and recurrent inflammation. This study aims to provide valuable insights into the risk factors, pathogenesis, and histopathological diagnosis and differentiation of these conditions, enhancing their understanding and management. The etiopathology of these conditions is multifactorial, including mechanical irritation, inflammation, genetic factors, and environmental influences. Pterygium affects over 10% of the population and is characterized by abnormal growth of epithelial and fibrovascular tissue involving the conjunctiva. Risk factors include prolonged ultraviolet (UV) exposure, sunlight exposure, dry eye disease, and aging. Additional risk factors for recurrent pterygium are postoperative inflammation, excessive suturing, and incomplete primary pterygium removal. The role of humoral and cell-mediated immune responses in these lesions is critical. Pterygium, histopathologically displays abnormal bulbal conjunctival epithelium and submucosal fibrovascular connective tissue that migrates to and involve cornea. Elastosis is the key morphological finding in pterygia. Histopathologically, pyogenic granuloma shows vascular proliferation, acute and chronic cellular infiltrates, and mucosal thickening. Recurrent pterygium and pyogenic granuloma after surgical trauma are common and can cause significant morbidity. While all these can be clinically diagnosed; histopathological investigations aid confirmation. Accurate diagnosis and appropriate management are crucial to prevent ocular surface damage, visual impairment, and pterygium recurrence.
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