This document summarizes various degenerative conditions of the conjunctiva: Pinguecula presents as a yellowish patch near the limbus caused by collagen degeneration and hyaline deposition. Pterygium is a wing-shaped growth of conjunctiva onto the cornea caused by sun/dust exposure. Concretions are inspissated mucus deposits in conjunctival depressions. Amyloid deposition in the conjunctiva can occur primarily or secondarily to systemic disease/inflammation. Treatment involves removal of concretions or amyloid plaques and excision/grafting of pinguecula or pterygium.
This document summarizes various degenerative conditions of the conjunctiva: Pinguecula presents as a yellowish patch near the limbus caused by collagen degeneration and hyaline deposition. Pterygium is a wing-shaped growth of conjunctiva onto the cornea caused by sun/dust exposure. Concretions are inspissated mucus deposits in conjunctival depressions. Amyloid deposition in the conjunctiva can occur primarily or secondarily to systemic disease/inflammation. Treatment involves removal of concretions or amyloid plaques and excision/grafting of pinguecula or pterygium.
This document summarizes various degenerative conditions of the conjunctiva: Pinguecula presents as a yellowish patch near the limbus caused by collagen degeneration and hyaline deposition. Pterygium is a wing-shaped growth of conjunctiva onto the cornea caused by sun/dust exposure. Concretions are inspissated mucus deposits in conjunctival depressions. Amyloid deposition in the conjunctiva can occur primarily or secondarily to systemic disease/inflammation. Treatment involves removal of concretions or amyloid plaques and excision/grafting of pinguecula or pterygium.
This document summarizes various degenerative conditions of the conjunctiva: Pinguecula presents as a yellowish patch near the limbus caused by collagen degeneration and hyaline deposition. Pterygium is a wing-shaped growth of conjunctiva onto the cornea caused by sun/dust exposure. Concretions are inspissated mucus deposits in conjunctival depressions. Amyloid deposition in the conjunctiva can occur primarily or secondarily to systemic disease/inflammation. Treatment involves removal of concretions or amyloid plaques and excision/grafting of pinguecula or pterygium.
CONJUNCTIVA Conjunctiva recap • Conjunctiva is a translucent mucous membrane which lines the posterior surface of the eyelids and anterior aspecr of eyeball. Degenerative conditions of Conjunctiva:
• Pinguecula • Pterygium • Concretions • Amyloid degeneration PINGUECULA • Pinguecula is an extremely common degenerative condition of the conjunctiva.
• Characterised by formation of a yellowish white
patch on the bulbar conjunctiva near the limbus.
• Named so because of its resemblance to pinguis,
which means fat. Pinguecula ETIOLOGY: Pinguecula has been considered as an age change occuring more commonly in persons exposed to strong sunlight,dust ,wind. PATHOLOGY There is an elastotic degeneration of collagen fibres of the substantia propria of conjunctiva coupled with deposition of amorphous hyaline material in the substance of conjunctiva. CLINICAL FEATURES-PINGUECULA • Bilateral usually stationary condition • Presents as yellowish white triangular patch near the limbus • Apex of the triangle away from the cornea. • Affects the nasal side first and then the temporal side. COMPLICATIONS • Inflammation • Intraepithelial abscess formation • Rarely calcification and pterigium formation
TREATMENT In routine no treatment is required.When inflamed it is treated with topical steroid. Pterygium • Pterygium is a wing shaped of conjunctiva encroaching upon the cornea from either side within the interpalpebral fissure.
• Etiology is not definitely known but suggested it is in
response to prolonged effect of sun (uv rays),dry heat, abundance of dust. PATHOLOGY:
• The subconjunctival tissue undergoes elastotic
degeneration and proliferates as vascularised granulation tissue under the epithelium,which ultimately encroaches the cornea
• The corneal epithelium,Bowman’s layer and
superficial stroma are destroyed. CLINICAL FEATURES • Seen in old age • More common in males • Unilateral or bilateral-usually in the nasal side • Asymptomatic in early stages • Symptoms: Foreign body sensation,irritation,diplopia.
Defective vision occurs when it approaches the
puppilary area. • Signs :Pterygium presents as a triangular fold of conjunctiva • encroaching on the cornea on the nasal side. RECURRENCE OF PTERYGIUM Recurrence after surgical excision can be reduced by
• Surgical excision with free conjunctival limbal autograft(CLAU)
• Surgical excision with amniotic membrane graft and
mitomycin C
• Surgical excision with lamellar keratectomy and lamellar
keratoplasty SURGICAL EXCISION OF PTERYGIUM –STEPS • Topical anasthesia • Head of pterygium is lifted • Main mass of Pterygium is then seperated from sclera underneath and conjunctiva above • Pterygium tissue is then excised • Haemostasis is achieved & episcleral tissue cauterised • Conjunctival limbal autograft (CLAU) transplantation • (Use of fibrin glue to stick the autograft in place reduces time) Concretions Concretions • Concretions are formed due to accumulation of inspissated mucus and dead epithelial cell debris into the conjunctival depression called loops of Henle.
• Commonly seen in elderly people and
In patients with scarring stage of trachoma.
• The name concretion is a misnomer,they are
not calcareous deposits. Clinical features: • Seen on the palpebral conjunctiva,more commonly on the upper than lower. • They are yellowish white,hard looking,raised areas • Size varies from pin point to point head. • Being hard,they may produce foreign body sensation Treatment Consists of their removal with the help of hypodermic needle under topical anasthesia AMYLOID DEGENERATION OF CONJUNCTIVA Amyloid degeneration of Conjunctiva • Conjunctival amyloid occurs rarely.
• Reported in two forms
• Primary conjunctival amyloid- associated with deposition of light
chain immunoglobulin by monoclonal b cells and plasma cells.
• Secondary conjunctival amyloid-Occurs secondary to systemic
diseases or conjunctival inflammation. Clinical features: • Deposition of yellowish,well demarcated,irregular amyloid material in conjunctiva with superior fornix and tarsal conjunctiva morr commonly involved.
Treatment: • Lubricating drops • Excision biopsy can be performed in patients with marked irritation. Degenerative conditions of Conjunctiva:
