Saturday, September 5, 2015

A 50 Year Old Man Presents With A Growth In His Eye

A 50 year old man presents to his general physician as he is concerned about something growing in his eye and wonders if it is something serious and needed to be removed. He denies any problem with his vision but he has noticed his eyes often to be dry and irritated. He has spent most of his life working outdoors, with exposure to environmental pollutants. .
The picture and the lesion in his eye is shown below:


What is the diagnosis:?
.
Pterygium.

Case Discussion:

A pterygium is a generally benign growth of fibroblastic tissue on the eye of an adult with chronic UV exposure. Pterygia can be unilateral or bilateral, are usually located on the nasal side, and extend to the cornea. Pterygia often require no treatment, but can be removed surgically if they interfere with vision. Patients with dry eyes are prone to the development and progression of pterygia.

Pterygium most often develops between the ages 20 and 50 years. The frequency of pterygium increases with sun exposure and age.

Etiology: The etiology of pterygium is incompletely understood; however, chronic UV exposure is accepted as a causative agent. Chronic inflammation and oxidative stress may also play a role in
pathogenesis.

Clinical features: Include redness, itching and irritation of the involved eye. Some patients may have no symptoms other than seeing abnormal tissue on the eye. Visual blurring may occur if the pterygium grows over the visual axis.

Diagnosis: is clinical by its distinctive appearance. 

Differential Diagnosis:
  • Pinguecula : a  yellowish patch or nodule on the conjunctiva and does not extend onto the cornea.
  • Conjunctivitis:  discomfort and eye discharge but resolves in a short time. 
  • Squamous cell carcinoma of the conjunctiva : very rare.
Management;
1. Avoid exposure to sunlight and use UV filtering sunglasses.
2. Artificial tears and topical lubricating drops help in soothing the inflammation and symptoms of dry eye. 
3. Surgery to remove Pterygia is only done if it interferes with normal vision. 

2 comments:

  1. Hello, my name is Betty. i was diagnosed of HIV virus 4 years back. Before then, i was dating this Derrick guy. we had something great going on. Our love life only lasted for 8 months. the sixth and seven month of our relationship, i began feeling very weak every now and then. But i never suspected anything until I kept on experiencing different symptoms like having sore throats, constant headache, body weakness e.t.c. I decided to go for a medical check up. I was tested HIV positive. when the doctor broke the news to me, it was as if my whole world had crumbled. it dawned on me then that Derrick has been lying to me. i was very mad to an extent i almost committed suicide. But there was nothing i could do, other than weep and weep. ever since then, i have been spending heavily on medications, going from one medical clinic or the other so I can look healthy. Though since i was a kid, i love herbs a lot. i take herbal tea with grandma while growing so i am quite familiar with herbs. early last year, i was on the internet and on a particular health blog, to check for herbal medication as alternative. I saw many comments and read many testimonies. Until i came across a particular testimony on how Dr.ugo cured a patient from herpes simplex virus using pure natural herbs. i reached out to the doctor because I also was thinking Herpes had no cure. I told him about my HIV status.He encouraged me not to panic that he will help me get my deliverance. he prepared some herbs and sent them to me. The herbs were in four 70ml bottles and I took them morning and night. i used as he directed, and in less than three weeks, i started having appetite to eat plenty of food and i gained back my strength. the fourth week,I consumed all the herbal meds. He encouraged me to go for a test which i did. This time, the result was negative. I quickly contacted the doctor and informed him of the news. I immediately asked him to prepare for Derrick too. He did and sent it. Today, me and Derrick are HIV free. All thanks goes to God Almighty for healing us through Dr.Ugo. if you are having any kind of sickness at all, Dr.Ugo is the right person to talk to and i assure you, you will be glad you did. His email: ugoherbalhome@gmail.com you can also write him on WhatsApp +2348104990619.

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