The guidelines presented by the New York State Workers Compensation Board provide fundamental principles for addressing Pterygium. These directives are designed to assist healthcare professionals in identifying appropriate therapeutic approaches within the context of a comprehensive assessment.
Healthcare professionals with expertise in managing Pterygium can rely on the guidance outlined by the Workers Compensation Board to make well-informed decisions about the most suitable therapeutic methods for their patients.
It is crucial to emphasize that these guidelines are not meant to substitute clinical judgment or professional expertise. The ultimate decision regarding the management of Pterygium should involve collaboration between the patient and their healthcare provider.
Pterygium is a weird growth—it’s like this triangular fold of tissue that slowly moves across the cornea, usually starting from the nasal side. Sometimes, you might see some inflammation in the conjunctiva around it. It’s more common in tropical or dry areas and among folks who spend a lot of time outdoors getting hit with ultraviolet rays. Usually, it’s more of a cosmetic issue, but for some unlucky folks, it can cause symptoms. If this growth starts messing with your line of sight, though, surgery to cut it out is the way to go.
Treatments
NSAID Ophthalmic Drops: Don’t bother with NSAID drops for irritated pterygia or pingueculae—it’s not recommended.
Glucocorticosteroid Drops: For those red and inflamed pterygia or pingueculae, go for glucocorticosteroid drops. It’s generally a good idea to start with artificial tears first since they have fewer side effects. Keep in mind, though, that these steroid drops might mess with your intraocular pressure (IOP), so only an eye expert or a provider who can regularly check IOP should prescribe them. Follow the manufacturer’s recommendations for how often and how long to use them. In one trial, they used 0.1% dexamethasone drops six times a day for three days, then four times daily for two weeks.
Indications for Discontinuation: Stop using the drops when your symptoms clear up, you can’t tolerate them, you experience side effects, or you finish the recommended course.
Pterygium Surgical Excision: If you’ve got pterygia hanging out near or messing with your line of sight, especially if they’re always irritated or not responding to eye drops, surgical removal is the way to go. This is particularly true for those causing impending visual issues. Sure, surgery is a bit invasive and can have its downsides, but it’s recommended selectively to prevent serious complications and save your sight.
Bevacizumab: For keeping those pterygia from making a comeback, consider using Bevacizumab. This is especially recommended after surgical removal, especially for younger patients who are more prone to having these things show up again. If you can’t stand it, experience side effects, or finish the recommended course, it’s time to call it quits.
