Snapshot A 66-year-old man presents to his primary care physician for evaluation of an abnormal growth of the eye. He reports that his wife noticed this growth. He denies any pain, discomfort, or impairment in his visual field in the affected eye. He denies having any chemical exposure to his eyes. Medical history is unremarkable. He works as a farmer and reports spending most of his day out in the field. On physical exam, there is a wedge-shaped growth extending onto the cornea. Introduction Definition a collection of fibrovascular conjunctival tissue Epidemiology Incidence most common in tropical regions Risk factors chronic sun exposure (especially ultraviolet light) ETIOLOGY Pathogenesis likely multifactorial, involving neovascularization and extracellular matrix remodeling Presentation Symptoms patient concerned for cosmetic reasons may have mild visual impairment Physical exam redness and irritation wedge-shaped growth extending onto the cornea Studies Making the diagnosis this is a clinical diagnosis based on history and physical exam Differential Pinguecula differentiating factors round, yellowish, and elevated growth Treatment Operative surgical excision indication definitive therapy used when the pterygium involves the visual axis or has an appearance concerning for dysplasia Complications Recurrence post-excision Post-surgical complications (e.g., bleeding and infection) Prognosis May lead to visual impairment and reduced ocular motility if not treated Can lead to cosmetic concerns There is a > 90% recurrence within the first 12 months after the pterygium is excised