Pterygium

So I had interview #1 for fellowship yesterday. It was interesting to say the least. I think I could write a whole article on the poor planning, how I was asked about my personal life (this is actually not allowed, by the way), no lunch was planned etc. It wasn't one of my top choices for fellowship so the good thing is that I got to do a practice interview. I was pimped on amiodarone-induced thyroiditis and vit D deficiency so more on that later. The other useful thing is that now I know what parts of my resume to be prespared about and I'll be more prepared to answer questions about what I want to do in 5-10 years from now.
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But first about pterygia (the plural of pterygium) which I think is a feat in itself just to spell. Apparently they are like a joke to the opthalmology guys since they are relatively benign, but they bug patients a lot because of the cosmetic defect as well as the irritation to the conjunctiva.

They are more prevalent in African-American and pts who do outdoor work and have high exposure to UV light. They are often confused with pinguecula which arises from the limbus and stays within the cornea.

Patients don't usually present until:
(1) the growth extends onto the cornea
(2) the growth impinges onto the pupil

If surgery doesnt need to be done then the patient can be treated with drops, ointments, and gels to lubricate the eye. They can also use decongestants, NSAID and steroids, but these cause a rebound effect when stopped so they are not highly recommended.

They are also at higher risk for astigmatism and retinal detatchment.

Surgery is done when:
(1) the pterygium causes astigmatism (usually when it is >3mm)
(2) there is an opacity in the visual field
(3) either of the above is threatening to happen

The recurrence rate is 30-50%.