Pterygium is the degeneration, hypertrophy, and hyperplasia of the bulbar conjunctiva and subconjunctival tissue of the palpebral fissure, which develops into the cornea, and is triangular, like a wing shape, hence its name. It is more common in outdoor workers, and fishermen and farmers have the most disease. It may be related to long-term chronic irritation such as wind, sunlight, and smoke.
Because it is shaped like an insect’s wings, it is named after it. Chinese medicine called it Panjing. Pterygium is generally more common in the large corner of the eye, sometimes it can grow to the black eyeball, blocking the pupil and reducing vision. How is pterygium formed? Its cause is still unclear. It is generally believed that the disease is related to long-term field work, exposure to sand, dust, cold, heat and sunlight. At the same time, overwork, lack of sleep and chronic inflammation of the conjunctiva are also predisposing factors. Traditional Chinese medicine believes that this disease is related to the stagnation of wind and heat in the heart and lung meridians and stagnation of meridians. In recent years, it has also been believed that the pterygium is closely related to the overdevelopment of the control ligament of the medial rectus muscle and genetic factors.
1. Pterygium invades the pupil area and causes visual impairment;
2. The bulbar conjunctiva of the palpebral fissure is hyperplasia, hypertrophy, and triangular shape. The part where the pterygium enters the cornea is the head, the part that crosses the limbus is the neck, and the rest is the body;
3. The pterygium in the resting stage is characterized by thin hyperplastic tissue, non-congested body, flat head, and transparent and clear front cornea;
4. Pterygium in the advanced stage is hypertrophic tissue hypertrophy and hyperemia, the head is slightly raised, and the front cornea is infiltrated and develops toward the center of the cornea.
Diagnose based on:
The conjunctiva of the palpebral fissure is hypertrophy, hyperplasia, and invades the cornea, which is triangular shape.
The pterygium can be divided into three parts in terms of its shape: it grows on the black eyeball and is the tip of the pterygium, called the head. It is fanned backwards and slightly raised. The neck is located at the junction of black and white eyeballs. The broad part that stretches to the surface of the white eyeball is called the body, and there are many new blood vessels on it.
Pterygium can be divided into the following two types:
1. Progressive type: The pterygium has a wide neck, many new blood vessels, hyperemia, and hypertrophy. The body is triangular and stretches to both sides, the head is obviously raised, and it grows into the surface of the black eyeballs, even blocking the pupils.
2. Static type: The pterygium stops when it grows to the edge of the black eyeballs. It is not hyperemic, slightly red, with a flat head, thin neck and body, and is relatively static, but does not go away on its own.
In addition, there is a kind of pseudo-pterygium, which can grow on any part of the edge of the black eyeball. It is generally small and gray-white on the surface, but there are also thicker ones. Scar tissue is often formed due to trauma, corneal edge ulcers, chemical or thermal burns of the conjunctiva, and generally no longer grows after formation. It is completely different from the previous two types of pterygium in nature.
1. Drug treatment. For the stationary type, the pterygium does not invade the dark eyeballs and does not affect the vision, so treatment is not necessary. Patients with trachoma or chronic conjunctivitis can use antibiotics or glucocorticoid eye drops, such as 0.25% chloramphenicol or 0.5% cortisone eye drops, 3 to 4 times a day. For traditional Chinese medicine, you can use Xiaonuling eye drops to infuse your eyes, 4 times a day.
2. Those who have progressive pterygium or pterygium growing into black eyeballs that affect vision should go to the hospital for pterygium resection, but it is easy to relapse. 90 strontium radiation or beta radiation can be used after the operation if conditions permit to prevent postoperative recurrence. Of course, this kind of surgery must be done under a microscope to achieve the desired results. Chinese medicine believes that during the treatment period, patients should avoid eating irritating foods such as peppers and green onions, and avoid smoking and alcohol.
Modern medicine treatment:
Small and static pterygium does not affect vision and does not require treatment. Patients with trachoma or chronic conjunctivitis can use antibiotics or corticosteroid eye drops, such as 0.3% norfloxacin eye drops or 0.5% cortisone eye drops, 3 to 4 times a day.
If the pterygium grows into the black eyeballs and affects their vision, they should go to the hospital for surgical treatment. However, the recurrence rate after surgery is high, and the recurring pterygium progresses faster, and is often enlarged than the original one. Therefore, the operation must be taken seriously, carefully considered before the operation, and the operation must be thorough to reduce the possibility of recurrence. Commonly used surgical methods include pterygium burying and pterygium excision and conjunctival flap transplantation. In order to prevent recurrence, β-rays can be irradiated after surgery. Thiotepa, mitomycin C, bleomycin and other eye drops have a certain effect, but their side effects should be noted. Progressive pterygium surgery has a high recurrence rate, and 0.5% cortisone eye drops are applied early after surgery, 4 to 6 times a day. Corticosteroids are mainly used to inhibit the growth of capillary angiogenesis and fibroblasts in the traumatic area, reduce postoperative inflammation and the formation of granulation tissue, and have no direct effect on preventing recurrence.
Traditional Chinese Medicine Treatment (Treatment pterygium without surgery):
When syndrome differentiation of pterygium, local symptoms should be combined with systemic syndromes. It is true that the pterygium has sharp head, red color, thick body, and more tears; flat head, white color, and thin body are considered to be less evil and windy in syndrome differentiation. The difference between heat, actual heat and virtual heat. In the treatment, the actual fire should be reduced, and the virtual fire should be cleared. At the same time, it should be applied to the body of the pterygium with the external use of eight treasure eye drops or red eye powder. If the drug is ineffective and develops rapidly, it should be treated with hook-cutting technique. During the treatment period, irritating foods such as peppers and green onions should be fasted, and alcohol should be banned. The incidence of pterygium has an important relationship with environmental factors. To prevent pterygium, attention should be paid to avoid the eyes being stimulated by wind, sand, smoke, harmful gases, excessive sunlight and cold, etc., pay attention to eye hygiene, and treat trachoma or chronic conjunctivitis in time. At the same time, pay attention to adequate sleep, regular life, and avoid dry stools, etc.
Preventing pterygium is mainly to avoid smoke, dust, sand and sun stimulation as much as possible, pay attention to eye hygiene, and treat trachoma or other types of conjunctivitis in time. At the same time, pay attention to adequate sleep, regular life, and avoid dry stools and other systemic adjustments.
For the primary pterygium that has not yet invaded the cornea in the early stage, argon laser or local injection of pingyangmycin can be used for treatment. Once the pterygium grows into the corneal tissue and bulges, it should be surgically removed. After pterygium undergoes surgery according to the traditional method, the recurrence rate is relatively high, about 30%-40%. The stimulation of the operation causes the chemotaxis and aggregation of polymorphonuclear leukocytes (they can release vascular growth factors), which is the cause of neovascularization and recurrence after surgery.