Israel Medical Association Journal

Background: Corneal erosions, a common and very painful ailment, are traditionally treated with pressure patches and antibiotic ointment but the healing is slow.

Objectives: To report our experience with the use of therapeutic contact lenses for the primary treatment of traumatic corneal erosions.

Methods: During the last 5 years in a single community clinic 65 consecutive patients with traumatic corneal erosions were treated with a corneal contact lens and antibiotic drops as a routine measure. The charts were reviewed for outcome, side effects and complications.

Results: Healing of the corneal erosions occurred within 1 to 3 days in all patients, with minimal or no pain. No corneal infection occurred. One patient had a recurrence that was successfully treated by lens placement.

Conclusions: The therapeutic contact lens with antibiotic drops is a safe and effective method to treat traumatic corneal erosions, and patients can immediately resume their regular activities.

Background: The time to recurrence after surgical removal of primary pterygium (pterygium) and the association between the rate of recurrence and the postoperative interval remain unclear.

Objective: To determine the amount of follow-up time needed to identify recurrence in patients after surgical removal of pterygium.

Methods: We rviewed the files of 143 patients (143 eyes) with recurrent pterygium to determine the interval from surgery to recurrence.

Results: Almost all (91.6%) of the recurrences appeared by 360 days after surgery.

Conclusions: One year is the optimal follow-up time to identify recurrence of pterygium.

Background: Previous work has suggested an association between increasing size of pterygium and increasing degrees of induced corneal astigmatism.

Objectives: To assess the quantitative relation between pterygium size and induced corneal astigmatism using a computerized corneal analysis system (TMS II) and slit-lamp beam evaluation of pterygium size, and to conclude whether corneal astigmatism is an early indication for surgical intervention.

Methods: We evaluated 94 eyes of 94 patients with unilateral primary pterygium of different sizes, using TMS II and slit-lamp beam measurements of the size of the pterygium (in millimeters) from the limbus to assess parameters of pterygium size with induced corneal astigmatism. Best corrected visual Snellen acuity was performed.

Results: Primary pterygium induced with-the-rule astigmatism. Pterygium extending 16% of the corneal radius or 1.1 mm or less from the limbus produced increasing degrees of induced astigmatism of more than 1.0 diopter. Significant astigmatism was found in 16.16% of 24 eyes with pterygium of 0.2 up to 1.0 mm in size, in 45.45% of 22 eyes with pterygium of 1.1 up to 3.0 mm in size (P≤0.0004), and in 100% of 3 eyes with pterygium of 5.1 up to 6.7 mm in size (P=0.0005). We found that visual acuity was decreased when topographic astigmatism was increased.

Conclusions: When primary pterygium reaches more than 1.0 mm in size from the limbus it induces with-the-rule significant astigmatism (≥1.0 diopter). This significant astigmatism tends to increase with the increasing size of the lesion. Topographic astigmatism tends to be improved by successful removal of the pterygium. These findings suggest that early surgical intervention in the pterygium may be indicated when the lesion is more than 1.0 mm in size from the limbus.