Pterygium is an invasive ocular surface disease characterized by proliferation, inflammatory infiltrates, fibrosis, angiogenesis, and extracellular matrix breakdown. It is a common disorder of the ocular surface, with a prevalence of 2% in temperate areas and up to 20% in tropical regions.
1 The pathogenesis of pterygia has intrigued researchers for centuries, but it is not completely understood. Studies have shown an increasing prevalence of pterygia with closer proximity to the equator, secondary to greater exposure to UV radiation.
2,3 Coroneo et al
4-6 proposed an initial alteration of limbal stem cells as a result of chronic UV exposure, with a resultant breakdown of the limbal barrier leading to conjunctivalization of the cornea. Recently, more direct proof of the hypothesis that pterygia develop from limbal epithelial progenitors has been provided with evidence that Fuchs islet cells have stem cell characteristics.
7 Other investigators have proposed neoplastic factors, focusing on the p53 tumor suppressor gene,
8,9 whereas some believe tear film abnormalities and allergic factors are significant contributors.
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