Blindness Caused by Pterygium – A Case Report

Abstract

Pterygium leading to bilateral blindness and forcing patient to quit job is uncommon. This is a case report of a 46 year old indigent woman who had blinding pterygia over 10 years. She could not afford pterygium excision offered in a private eye clinic where she initially presented after a period of unsuccessful self medication. She was forced out of sewing job consequent to her inability to thread needle, difficulty reading number on the tape rule and difficulty recognising faces of her clients. Six years later, she presented at eye clinic of the University of Ilorin Teaching Hospital, Nigeria with advanced bilateral pterygia. Having defaulted from clinic over 4 months for lack of fund, the patient, after concession, had successful bilateral pterygia excision using bare sclera technique with Mitomycin C (MMC) dab. There was restoration of the lost vision. Pterygium is a cause of avoidable blindness with consequential impact on quality of life. Eye care providers should identify individual patient challenges to reduce avoidable blindness. INTRODUCTION Pterygium is a common eye condition notorious for conjunctiva redness (which may be of cosmetic implication), lacrimation, itching / grittiness that may cause insomnia/psychological upset and visual impairment resulting from induced astigmatism, glare, and decreased contrast sensitivity (Lin et al., 1989). It is a triangular or wing-shaped conjunctiva encroachment on the cornea, may be atrophic, stationary or progressive (Johnson, 2003; Luanratanakorn et al., 2006) and could induce diplopia. Histologically, pterygium contains elastotic degenerated collagen tissue of the stroma of the conjunctiva. It can be unipolar usually nasal, or temporal. It can be nasally and temporally located, bipolar while bilateral and not necessarily symmetrical do occur. There may be cystic changes of the lesion and rarely calcification and neoplastic transformation are seen (Khamar et al., 2005). Pterygium exists worldwide however; it is more common in region between latitudes 40 0 north and south of the equator (Johnson, 2003). Pterygium