A 55-year-old man with a history of chronic blepharitis develops a triangular, wing-shaped fibrovascular growth on the nasal conjunctiva that has encroached 3 mm onto the cornea, causing induced astigmatism. Which feature of this lesion indicates surgical removal?

• A Location on the nasal side
• B Presence of Stocker line
• C Encroachment within 3 mm of the visual axis
• D Induced astigmatism causing significant visual impairment ✓

Explanation

A pterygium requires surgical excision when it causes significant induced astigmatism with visual impairment, threatens to encroach on the visual axis (central 4 mm zone), or causes persistent symptoms unresponsive to medical therapy. Stocker line (iron line at the leading edge) indicates a slowly growing pterygium and is not itself an indication for surgery. The combined conjunctival autograft technique reduces recurrence rates significantly.

Reference: Khurana Comprehensive Ophthalmology, 7th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.