A fleshy object protruding from the conjunctiva of the eyeball
Pterygium, pinyin: n ǔòòòòò u, refers to the fleshy substance protruding from the hyperplasia of the conjunctiva of the eye in traditional Chinese medicine.Not coveredCornealIt is called 'pterygium' and it covers the cornea‘Pterygium climbing eyes’。PterygiumIn terms of its shape, it can be divided into three parts: it grows on the black eyes and is the tip of the pterygium, called the head.Rearward, fan-shaped and slightly raised, the neck is located at the junction of black and white eyes.The width that extends to the surface of the white eye is mostly called the body, and there are many on itNeovascularization。
Chinese name
Pterygium
Pinyin
nǔ ròu
Definition
A fleshy object protruding from the conjunctiva of the eyeball
Progressive type: wide neck of pterygium,NeovascularizationIt is hyperemic, hypertrophic, and the body extends to both sides in a triangle shape. The head is obviously raised, growing into the surface of black eyes, or even blockingpupil。
Static
Static type: The pterygium stops when it grows to the edge of the black eye. It is not congested, reddish, flat head, thin neck and body, and is in a relatively static state, but does not disappear automatically.
There is another kind of hypocrisyPterygiumIt can grow at any part of the edge of the black eye. It is generally small, and the surface is grayish white, but there are also thicker eyes.Often due to traumaCornealEdge ulcer, conjunctival chemistry orThermal burnformationscar tissue It generally does not grow after formation.It is completely different in nature from the previous two pterygium.
Causes
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PterygiumBulbar conjunctiva and fiberVascular tissueWing like intrusionCornealThe superficial layer is a lesion caused by the proliferation and degeneration of conjunctival tissue.It is generally believed that after long-term exposure to smoke, sandstorm and sunlight, the conjunctival connective tissue is denatured, proliferated and hypertrophic due to cold and heat stimulationBulbar conjunctivaThe subconjunctival tissue invades the corneal surface from the bulbar conjunctiva, and its shape resembles the wings of insects.Pterygium inTraditional Chinese MedicineIs called“Pterygium climbing eyes”Chinese medicine believes that this disease is mainly caused by external factors, dietseven human emotions, fatigue, etc., make the viscera disorder, evil heat attack the eyes, and blood stagnation in the canthus.If the eye fissure is often stimulated by sand, smoke or sunlight, it can accelerate the breeding and development of pterygium.It is also believed that pterygium is closely related to the overgrowth of the restraining ligament of the ocular rectus muscle and genetic factors.
Treatment and prevention
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(1)PterygiumHead subconjunctival transplantation: suitable for pterygium with thin and mild hyperemia.This kind of operation method is simple, but it is easy to form wrinkles in the local area after the operation, which is hypertrophic and easy to recur. It has been rarely used.
(2) Simple excision of pterygium: suitable for pterygium invasionCornealMore, and progressive pterygium or nearpupilThose who threaten the visual function of the eyes, or those who have cataractkeratoplastyThose whose incision affects or will stimulate the development of pterygium after surgery, or whose pterygium will hinder the beauty of the patient.This method of operation is also relatively simple, and the operation time is relatively short, but it is easy to recur after operation.
(3) Pterygium excision combined with free conjunctival flap transplantation: suitable for patients with large pterygium, hyperemia and hypertrophy, and rapid growth, orPterygium excisioninconjunctivaThose with more missing.The operation of this method is relatively complicated and difficult, and the conjunctival flap used for transplantation should especially prevent the inversion of the front and the back, but the operation effect is good and the postoperative recurrence rate is relatively low.
(4)PterygiumExcision and pedicled conjunctival flap transplantation: This operation method is also applicable to those with hypertrophic and congested pterygium and fast growth.Because the conjunctiva is elastic and has good compliance, it can be used to separate the bulbar conjunctiva adjacent to the pterygium excision area, cut it for appropriate release, and then transplant it to repair the exposed sclera area.This method will not cause conjunctival flap inversion, and the blood supply is good, and the transplanted conjunctiva grows and heals faster.The disadvantage is that there may be a certain tension when the conjunctiva is pulled and displaced, so it should be well aligned when sewing the wound to prevent the conjunctival wound from splitting.
No matter which method is used, pterygium has the possibility of recurrence, so it must be explained to the patient in advance.In order to prevent the recurrence of pterygium after surgery, the key points of each step, such as pterygium stripping, cleaning of tissue under pterygium, sclera exposure orconjunctivaThe use of grafts should be handled carefully.Postoperative adjuvant treatment YesPrevent recurrenceIt also has a certain effect.If 0.5%~2.5% cortisone eye drops are used 4 times a day for 1 month after surgeryNeovascularization；1: 2000 Thiotepa solution eye drops, 4 times a day, lasting for 1-3 months;Or use X-ray or β ray irradiation to prevent recurrence of pterygium.
To prevent pterygium, we should try our best to avoid smoke, sand and sunlight, and pay attention to eye hygienetrachomaOr other types of conjunctivitis should be treated in time. At the same time, attention should be paid to adequate sleep, regular life, and avoidingDry stoolSuch as the adjustment of the whole body.Do not eat spicy food such as pepper and green onion, and do not smoke or drink.
Treatment of pterygium
Small and static pterygium, which does not affect vision, does not need treatment.Consolidated withtrachomaorChronic conjunctivitisAntibiotics orCorticosteroidseyedropEye 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 eyes and affects the vision, the patient should go to the hospital for surgery.However, the recurrence rate after surgery is high, and the recurrent pterygium progresses rapidly and often expands compared with the primary pterygium. Therefore, surgery must be taken seriously, and careful consideration should be taken before surgery. Thorough care should be taken during surgery to reduce the possibility of recurrence.The commonly used surgical methods are pterygium embedding and pterygium excision and conjunctival flap transplantation.In order to prevent recurrence, beta ray, thiotepamideMitomycin C、ZhengguangmycinThe eye drops have certain curative effects, but attention should be paid to its side effects.The recurrence rate of progressive pterygium after surgery is high, and 0.5% cortisone is used early after surgeryeyedrop, 4-6 times a day.cortexSteroidsIt is mainly used to inhibit capillary neogenesis and fibroblast growth in the trauma area, and reduce postoperativeinflammatory reaction andgranulation tissue It has no effect on preventing recurrence directly.
Traditional Chinese medicine treatment: the local symptoms should be combined with the systemic symptoms when the disease is differentiated, and the pterygium tip, red color, body thickness, and many sleep tears are true;Those with flat head, white color and thin body are characterized by low evil spirit. The syndrome differentiation can be divided into wind heat, excess heat and deficiency heat.In the treatment, it is better to purge the excess fire and clear the deficiency fire. At the same time, it is better to apply Babao eye medicine or red eye powder to the pterygium.If the medicine is ineffective and develops rapidly, the hook cutting technique should be used for treatment.
During the treatment period, people should not eat spicy food such as pepper and green onions, and should not smoke or drink.PterygiumThere is an important relationship between environmental factors and the incidence of SARS.To prevent pterygium, attention should be paid to avoiding eye irritation caused by sandstorm, smoke, harmful gas, excessive sunlight, cold and other factors, and paying attention to eye hygienetrachomaorChronic conjunctivitisIt should be treated in a timely manner. At the same time, attention should be paid to adequate sleep, regular life, and avoiding dry stools.
Difference between pseudopterygium and palpebral fissure
Pterygium is similar to pseudopterygium and blepharoplasma, which should be distinguished clinically.Pseudopterygium grows at any part of the edge of the black eye. It is generally small and has no development trendCornealIt is caused by epithelial adhesion.A cord or triangle can be seen clinicallyconjunctivaThe folds are fixed atCorneal opacificationLocation, mostly inCorneal ulcer, burn or chemical corrosion.Because the conjunctiva is only attached to the cornea at the head, the probe can be used to pass under the neck smoothly, unlike true pterygium, which is fully attached to the surrounding tissue.
Palpebral fissureIt is caused by ultraviolet radiation of sunlightBulbar conjunctivaDegenerative lesion, located in the bulbar conjunctiva of the palpebral fissure,Limbus corneaeThere are yellow white amorphous raised spots on the inside and outside, which can gradually expand after a certain period of time and do not invade the cornea, so it only slightly affects the beauty, so it usually does not need treatment.
High incidence season
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Severe sandstorm and dry weather in spring are inducedPterygiumThe main cause of common diseases in spring.
Most of the patients came to perform pterygium excision.Ophthalmology experts remind that the sandstorm and dry weather in spring are easy to induce common diseases in spring, such as pterygium, and hope that the general public pay attention to prevention.The incidence of pterygium is closely related to environmental factors.Its concentrated outbreak during this period is related to the environmental stimulation of cold weather, dry climate and more sandstorms in the previous period.At the initial stage of pterygium, palpebral fissure ballConjunctival congestionHypertrophy, graduallyCornealThe surface extends to form a triangle withVascular tissueThe pterygium of pterygium is similar to the wing of an insect and usually occurs on the nasal side.In the early stage of the disease, most patients have no conscious symptoms and generally do not pay attention to them.But if the central part of the cornea is allowed to develop, it will causeastigmatismIf serious, it will affect vision and limit eye movement.Don't drip freely when your eyes are itchyeyedrop, PreventionPterygiumAttention shall be paid to avoid eye irritation caused by wind sand, smoke, harmful gas, excessive sunlight, cold and other factors.
At ordinary times, pay more attention to eye hygiene, and ensure adequate sleep and regular life.If the patient feels unwell to the eyes, it is better to go to an ophthalmic hospital for examination. If the vision is seriously affected, surgery can be performed as needed.Some patients reject the operation. In fact, the operation is just for treatmentPterygiumIt can avoid recurrence to some extent.And the surgical treatment has been quite advanced, so patients need not worry.People should pay more attention to "allergic eye disease", "red eye disease" and other common eye diseases in spring.In case of eye abnormalities, itching, pain and other conditions, it is better to go to the ophthalmic hospital for diagnosis in time. Do not buy medicine or eyedrops at will, because many eyedrops contain antibiotics, too many drops are easy to cause dependence, and some eyedrops contain preservatives, which willCornealCause injury.
