Abstract
Aims: To evaluate the clinical and histological status of tear film in patients with unilateral pterygium. Settings and Design: Cross-sectional, case-control, double-blinded study. Methods and Material: Cross-sectional study of both eyes of 102 patients with unilateral pterygium was conducted between March 2011 to December 2012. Patients were subject to fluorescein lower tear meniscus height (LTMH) evaluation, fluorescein tear break-up time (TBUT), Schirmer’s test (using topical anesthetic), vital staining (viz. fluorescein, Rose Bengal and lissamine staining), LTMH imaging with anterior segment spectral-domain optical coherence tomography (OCT) cornea-anterior module (CAM-L and CAM-S), and conjunctival smear impression cytology. The normal eye acted as control. Statistical analysis used: fisher’s t-test and chi-square test. Results: The study comprised of seventy males and thirty-two females in the age-range 28-76years. The mean fluorescein LTMH, mean TBUT, mean Schirmer’s test value, mean OCT CAM-S and CAM-L values in the normal control eyes were 0.36 ± 0.03 mm, 12.3 ± 1.9s, 13.4 ± 2.5 mm, 0.338 ± 0.082 mm and 0.325 ± 0.088 mm, respectively. The comparable values in eyes with pterygium were 0.24 ± 0.03 mm, 8.2 ± 1.4 sec, 9.2 ± 2.4 mm, 0.212 ± 0.046 mm and 0.204 ± 0.058 mm respectively. Goblet cell count was decreased in impression cytology. Conclusions: Both fluorescein and OCT LTMH were found to be significantly decreased (p<0.01) in eyes with pterygium compared to control eyes. Goblet cell count, TBUT and Schirmer’s test values were also comparatively decreased. This study thus emphasizes that tear film abnormalities play a role in aetiology of pterygium and hence early institution of therapy for tear film stabilization can help prevent the disease.
Highlights
Pterygium remains an oblivious dilemma except for its unanimously accepted description as a triangular, fibro-vascular sub-epithelial in-growth of degenerative conjunctival tissue encroaching onto the cornea
Pterygium justifies the adage “prevention is better than cure” and it becomes pertinent that we evaluate the status of tear film so as to find effective, documentable, time-efficient, and preferably non-invasive tools for detecting early tear film abnormalities and suggest remedial measures [8]
This study was conducted in our department on 102 (70 males/32 females) cases of unilateral pterygium attending the out-patient department or presenting to the out-reach team visiting the suburban areas of Agra
Summary
Pterygium remains an oblivious dilemma except for its unanimously accepted description as a triangular, fibro-vascular sub-epithelial in-growth of degenerative conjunctival tissue encroaching onto the cornea. Pterygium has preponderance in Agra with prevalence varying between 15-20 %. Agra features a semi-arid, subtropical climate, providing ideal conditions for studying tear film abnormalities in pterygium. Pterygium justifies the adage “prevention is better than cure” and it becomes pertinent that we evaluate the status of tear film so as to find effective, documentable, time-efficient, and preferably non-invasive tools for detecting early tear film abnormalities and suggest remedial measures [8]. The aforesaid study has been conducted with the following aims and objectives: To evaluate tear film qualitatively and quantitatively so as to deduce statistical correlation between tear film abnormalities and pterygium. To adjudge useful tools for tear film evaluation in pterygium
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