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Review Question - QID 106214

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QID 106214 (Type "106214" in App Search)
A 65-year-old man is brought to his primary care provider by his concerned wife. She reports he has had this "thing" on his eye for years and refuses to seek care. He denies any pain or discharge from the affected eye. A picture of his eye is shown below. Given the diagnosis, what are you most likely to discover when taking this patient's history?
  • A

He experienced shingles three years ago, with a positive Hutchinson's sign

8%

8/97

He suffered from recurrent conjunctivitis in his youth

19%

18/97

He grew up in Ecuador, where he worked outdoors as a farmer for 30 years

52%

50/97

He was involved in a bar fight and experienced a ruptured globe 10 years ago

6%

6/97

He suffered a burn to his eye while cleaning his bathroom with bleach 5 years earlier

14%

14/97

  • A

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The patient is most likely suffering from a pterygium. Living near the equator is associated with pterygium development.

Pterygium are benign growths of the conjunctiva associated with excessive exposure to wind, sunlight, or sand. Other risk factors include working outdoors with high exposure to UV rays. Symptoms of pterygium include persistent irritation, redness, foreign body sensation, and tearing. If the pterygium advances over the cornea it can impair vision.

Peate discusses work related eye injuries including corneal abrasions, burns, and globe injury. The review states that eye patching does not reduce discomfort following corneal abrasions. Working with chisels, hammers, grinding wheels, or saws places patients at risk for globe injuries. The treatment of chemical eye burns is immediate irrigation with copious amounts of fluid.

Janson et al. review the surgical management of pterygium. Pterygium are noncancerous proliferations of conjunctiva. Treatment is most often surgical and may be required because of discomfort, cosmesis, or obstruction of vision. Following surgical excision, pterygia can often recur.

Figure A displays a ptergium which is characterized by elastotic degeneration of collagen and fibrovascular proliferation.

Incorrect Answers:
Answers 1,2,4,5: These are not risk factors for pterygium formation.

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