Ophthalmology Expert Witness for Pterygium

A pterygium (pronounced ter-ig-eum) is a growth on the surface of the eye. It is much like a callous that develops in response to chronic irritation. Just as our skin reacts to constant irritation by forming a callous, so does the eye. The pterygium on the eye surface is usually caused by exposure to sun, wind, pollution, and smoke. Swimmers often develop pterygium from exposure to minerals in seawater or pool water. Pterygium usually develop along the white portion of inner corner of the eye. Blood vessels and scar tissue develops in the pterygium as they develop. Pterygiums grow very slowly, gradually growing over the clear part of the eye called the cornea. Only in extreme cases do they interfere with vision to a significant degree.  An ophthalmology expert witness is qualified to evaluate diagnosis and treatment of pterygium.

Signs and Symptoms

Dr. Reynard was retained as an expert to determine causation in a patient who had scleral thinning, blurred vision, and chronic low-grade eye pain following surgical removal of a pterygium.

When pterygium first begins, patients notice a small bump along the inner aspect of the eye. As they develop the eye may became irritated and red. Many patients experience constant tearing when the pterygium becomes inflammed Apterygium may interfere with vision if it grows across the cornea, especially if it involves the central portion of the cornea.

Treatment

To prevent pterygium growth it is important to wear sunglasses with ultraviolet (UV) protection when going outdoors. Some patients are advised to wear visors with a wide brim or a hat to shield the eyes from the sun. Swimmers are often advised to use a non-preserved eyedrop after swimming to wash out minerals and irritants from the eye. When pterygiums become large or bothersome, they may be removed as an out-patient procedure, either in our office or in the surgical center. Small pterygiumsmay be simply excised. Large pterygium may require a graft to help prevent recurrence.In certain cases a very mild form of radiation therapy may be used to help prevent recurrence. Generally, the bigger and more vascular a pterygium is before surgery, the greater the likelihood of recurrence after surgery.

Risks of Pterygium Surgery

  • Perforation or thinning of the outer eye tissue (sclera or cornea) from excessive tissue removal, overdose of radiation, or overdose of Mitomycin C.
  • Astigmatism that may be induced by altering the shape of the eye. Induced astigmatism may be temporary or permanent.
  • Infection from a variety of causes including inadequate preoperative preparation of the surgical site, inadequate antibiotic treatment, or exposure to infectious agents.

Case in Point

Dr. Reynard was retained as an ophthalmology expert witness to determine causation in a patient who had scleral thinning, blurred vision, and chronic low-grade eye pain following surgical removal of a pterygium.

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