Question

A patient presents in eye OPD with this finding. What is it?

• A. Dermoid
• B. Lipodermoid
• C. Pterygium
• D. Papilloma

Hint:

A triangular, wing-shaped fold of fibrovascular conjunctiva creeping from the nasal limbus onto the cornea is the giveaway.

Answer 1

The Correct Option is C

Step 1: Describe the lesion in the photo. The clinical photograph shows a triangular (wing-shaped) fold of fibrovascular conjunctival tissue encroaching from the nasal limbus onto the cornea, with its apex pointing toward the centre of the cornea. This is the hallmark of a pterygium.

Step 2: Recall the concept. A pterygium is a degenerative, UV-light/dust/wind-related overgrowth of bulbar conjunctiva (with elastotic degeneration of subconjunctival tissue) that grows across the limbus onto the cornea - most often from the nasal side. It can cause irritation, redness, astigmatism, and if it crosses the pupil, reduced vision.

Step 3: Confirm the answer. The triangular shape, nasal location, and crossing of the limbus onto the cornea are diagnostic of pterygium; option C is correct.

Step 4: Exclude the distractors. A (limbal) dermoid is a congenital, dome-shaped, rounded yellow-white solid mass that straddles the limbus, often at the inferotemporal limbus, and may bear hair - not a flat wing-shaped fold; A is wrong. A lipodermoid is a soft, yellowish, mobile subconjunctival fatty mass located at the temporal canthus/fornix, not crossing the cornea; B is wrong. A conjunctival papilloma is a fleshy, pink, lobulated cauliflower/raspberry-like growth, not a flat triangular limbal fold; D is wrong.

Final answer: Option C - Pterygium.