Pterygium Differential Diagnoses

Updated: Jul 15, 2019
  • Author: Jerome P Fisher, MD, FACS; Chief Editor: Hampton Roy, Sr, MD  more...
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DDx

Diagnostic Considerations

Consider pseudopterygium (eg, chemical or thermal burn, trauma, marginal corneal disease) in the differential diagnoses.

Consider neoplasia (eg, carcinoma in situ, squamous cell carcinoma, other neoplastic diseases) in the differential diagnoses.

Pingueculae (ie, actinic lesions confined to the perilimbal conjunctiva that do not extend onto the cornea) should also be considered in the differential diagnoses. [16]

Pingueculae are commonly occurring, generally small and asymptomatic (often yellow) raised nodules appearing on the bulbar surface of the conjunctiva. They are found more commonly on the nasal side, but they can also present either on the temporal conjunctiva or on both the nasal and temporal conjunctiva in the eyes of some patients.

Pingueculae are thought to be associated with actinic (sunlight) exposure in susceptible individuals.

Pingueculae can occasionally be subject to some inflammation with symptoms of itching, burning, or mild pain. In the absence of inflammation or of significant cosmetic complaints, pingueculae are generally ignored (by patient and physician alike). If mildly symptomatic, like pterygia, they can be treated with artificial tears.

On rare occasions, ocular anti-inflammatory drops may be required. On even more infrequent occasions, surgical excision may be of benefit in the management of pingueculae.

Histopathologically, pingueculae show mild-to-moderate focal thickening of the conjunctival stroma with elastotic degeneration of collagen.

Differential Diagnoses

  • Squamous Cell Carcinoma, Conjunctival