From the Guidelines
When treating an inflamed pterygium, topical corticosteroids should be used to control inflammation, as stated in the 2019 study by Ophthalmology 1. The treatment approach for an inflamed pterygium involves a step-wise strategy to reduce inflammation and alleviate symptoms.
- The primary goal is to control inflammation, and according to the study, this can be achieved by adding a topical corticosteroid once possible infection has been ruled out or controlled 1.
- Topical corticosteroids, such as prednisolone acetate 1% or fluorometholone 0.1%, can be used 4 times daily for 1-2 weeks to reduce inflammation.
- Additionally, cold compresses applied to the closed eyelids for 10-15 minutes several times daily can help alleviate discomfort.
- Patients should avoid eye irritants like smoke, dust, and excessive UV exposure, and wear UV-protective sunglasses outdoors.
- In some cases, a bandage contact lens may be necessary to alleviate symptoms, and a topical prophylactic broad-spectrum antibiotic should be considered to decrease the risk of secondary infection, as suggested by the study 1.
- Regular follow-up is necessary to reassess the patient's ocular status and re-emphasize the need for vigilance on the part of the patient.
- It is essential to note that the treatment approach may vary depending on the severity of the inflammation and the presence of other ocular conditions, such as dry eye disease, which may require additional management with preservative-free artificial tears 1.
From the Research
Treatment Options for Inflamed Pterygium
- Surgical management is the main treatment for pterygium, with various techniques such as Bare Sclera, Rotational Conjunctival Flap, Limbal Conjunctival Autograft, Amniotic Membrane Graft, and Free Conjunctival Autograft used for removal 2, 3, 4
- Auxiliary treatments such as mitomycin C, b-radiation, 5-fluorouracil, topical use of interferons, and Avastin are also effective in reducing the recurrence rate 2, 3, 5
- Nonsurgical treatment using topical dipyridamole has been reported to be effective in a case study, with marked improvement in both the pterygium and the patient's symptoms 6
- Loteprednol etabonate ointment has been shown to be a safe and effective component of the perioperative regimen for pterygium, although confirmatory prospective studies are needed 3
Considerations for Treatment
- The goal of pterygium treatment is to avoid recurrence, while also considering complication rates and cosmetic results 4
- The field of pterygium treatment is still evolving, with new strategies and approaches being developed to reduce the problem of recurrence 2, 5
- Treatment options may vary depending on the environment and resources available, with excision and adjunctive treatment with mitomycin C or conjunctival autograft being a popular mode of treatment 5