Tear film stability in patients with pterygium and normal healthy subjects: A cross-sectional comparative study.

Dr Mohammed  Haris; Dr. Boddupally  Soujanya

doi:10.51168/fj9jvp14

Authors

Dr. Mohammed Haris Senior Resident, Department of Ophthalmology, Government Medical College, Karimnagar, Telangana, India Author
Dr. Boddupally Soujanya Senior Resident, Department of Ophthalmology, Government Medical College, Nalgonda, Telangana, India Author

DOI:

https://doi.org/10.51168/fj9jvp14

Keywords:

Dry eye disease, Ocular Surface Disease Index, Pterygium, Schirmer test, Tear film break-up time, Tear film stability

Abstract

Background

Pterygium is a fibrovascular ocular surface disorder that can disturb tear distribution and produce symptoms of dry eye. Tear film instability is clinically important because it affects ocular comfort, visual quality and surface protection.

Objectives

To assess tear film stability in patients with pterygium, evaluate the same parameters in normal healthy subjects and compare the two groups.

Methods

This cross-sectional comparative study included 104 participants aged 18-60 years, with 52 patients having unilateral or bilateral pterygium and 52 normal healthy subjects. Tear film break-up time, Ocular Surface Disease Index score and Schirmer test values were recorded after slit-lamp evaluation. Group differences were analysed using appropriate statistical tests.

Results

The pterygium group had lower mean tear film break-up time than controls (8.12 ± 3.48 vs 11.38 ± 2.69 seconds; p<0.001). Mean Ocular Surface Disease Index score was higher in the pterygium group (30.44 ± 17.95 vs 16.96 ± 11.21; p<0.001). Mean Schirmer value was also lower among pterygium patients (13.37 ± 3.75 vs 15.77 ± 3.87 mm; p=0.002). Abnormal tear film break-up time and moderate-to-severe symptom burden were more frequent in the pterygium group.

Conclusion

Pterygium was associated with reduced tear film stability, greater dry eye symptom severity and lower tear secretion. Routine dry eye assessment in pterygium patients can support timely ocular surface management and improve clinical decision-making.

Recommendation

Patients with pterygium should undergo routine dry eye screening, early ocular surface treatment and follow-up to improve comfort and outcomes.

Author Biographies

Dr. Mohammed Haris, Senior Resident, Department of Ophthalmology, Government Medical College, Karimnagar, Telangana, India

is a Senior Resident in the Department of Ophthalmology at Government Medical College, Karimnagar, Telangana, India. He is actively involved in clinical ophthalmic care, patient evaluation, and academic activities within the department. His areas of professional interest include comprehensive ophthalmology, neuro-ophthalmic disorders, anterior segment diseases, and clinical research. He contributes to undergraduate teaching, departmental case discussions, and patient-centered ophthalmic practice. Dr. Haris is committed to improving visual health through evidence-based clinical care, continued academic learning, and research-oriented medical practice.
Dr. Boddupally Soujanya, Senior Resident, Department of Ophthalmology, Government Medical College, Nalgonda, Telangana, India

is a Senior Resident in the Department of Ophthalmology at Government Medical College, Nalgonda, Telangana, India. She is involved in clinical ophthalmology practice, patient evaluation, ophthalmic diagnostics and academic work. Her areas of interest include ocular surface disease, tear film assessment, anterior segment disorders, pterygium and dry eye-related clinical research. ORCID iD: https://orcid.org/0009-0004-4677-2556

References

Solomon AS. Pterygium. Br J Ophthalmol. 2006;90(6):665-666. doi:10.1136/bjo.2006.091413. PMID:16714259. https://doi.org/10.1136/bjo.2006.091413

Chu WK, Choi HL, Bhat AK, Jhanji V. Pterygium: new insights. Eye (Lond). 2020;34(6):1047-1050. doi:10.1038/s41433-020-0786-3. PMID:32029918. https://doi.org/10.1038/s41433-020-0786-3

Liu L, Wu J, Geng J, Yuan Z, Huang D. Geographical prevalence and risk factors for pterygium: a systematic review and meta-analysis. BMJ Open. 2013;3(11):e003787. doi:10.1136/bmjopen-2013-003787. PMID:24253031. https://doi.org/10.1136/bmjopen-2013-003787

Craig JP, Nichols KK, Akpek EK, Caffery B, Dua HS, Joo CK, et al. TFOS DEWS II Definition and Classification Report. Ocul Surf. 2017;15(3):276-283. doi:10.1016/j.jtos.2017.05.008. PMID:28736335. https://doi.org/10.1016/j.jtos.2017.05.008

Stapleton F, Alves M, Bunya VY, Jalbert I, Lekhanont K, Malet F, et al. TFOS DEWS II Epidemiology Report. Ocul Surf. 2017;15(3):334-365. doi:10.1016/j.jtos.2017.05.003. PMID:28736337. https://doi.org/10.1016/j.jtos.2017.05.003

Bron AJ, de Paiva CS, Chauhan SK, Bonini S, Gabison EE, Jain S, et al. TFOS DEWS II Pathophysiology Report. Ocul Surf. 2017;15(3):438-510. doi:10.1016/j.jtos.2017.05.011. PMID:28736340. https://doi.org/10.1016/j.jtos.2017.05.011

Wolffsohn JS, Arita R, Chalmers R, Djalilian A, Dogru M, Dumbleton K, et al. TFOS DEWS II Diagnostic Methodology report. Ocul Surf. 2017;15(3):539-574. doi:10.1016/j.jtos.2017.05.001. PMID:28736342. https://doi.org/10.1016/j.jtos.2017.05.001

Pflugfelder SC, Stern ME. Biological functions of tear film. Exp Eye Res. 2020;197:108115. doi:10.1016/j.exer.2020.108115. PMID:32561483. https://doi.org/10.1016/j.exer.2020.108115

Schiffman RM, Christianson MD, Jacobsen G, Hirsch JD, Reis BL. Reliability and validity of the Ocular Surface Disease Index. Arch Ophthalmol. 2000;118(5):615-621. doi:10.1001/archopht.118.5.615. PMID:10815152. https://doi.org/10.1001/archopht.118.5.615

Roka N, Shrestha SP, Joshi ND. Assessment of tear secretion and tear film instability in cases with pterygium and normal subjects. Nepal J Ophthalmol. 2013;5(1):16-23. doi:10.3126/nepjoph.v5i1.7816. PMID:23584641. https://doi.org/10.3126/nepjoph.v5i1.7816

Kadayifçilar SC, Orhan M, Irkeç M. Tear functions in patients with pterygium. Acta Ophthalmol Scand. 1998;76(2):176-179. doi:10.1034/j.1600-0420.1998.760210.x. PMID:9591948. https://doi.org/10.1034/j.1600-0420.1998.760210.x

Ye F, Zhou F, Xia Y, Zhu X, Wu Y, Huang Z. Evaluation of meibomian gland and tear film changes in patients with pterygium. Indian J Ophthalmol. 2017;65(3):233-237. doi:10.4103/ijo.IJO_743_16. PMID:28440253. https://doi.org/10.4103/ijo.IJO_743_16

Ozsutcu M, Arslan B, Erdur SK, Gulkilik G, Kocabora MS, Muftuoglu O. Tear osmolarity and tear film parameters in patients with unilateral pterygium. Cornea. 2014;33(11):1174-1178. doi:10.1097/ICO.0000000000000235. PMID:25255132. https://doi.org/10.1097/ICO.0000000000000235

Kucuk E, Yilmaz U, Zor KR. Tear film functions and dry eye symptoms in young patients with pterygium. Beyoglu Eye J. 2020;5(1):26-31. doi:10.14744/bej.2019.18853. PMID:35098058. https://doi.org/10.14744/bej.2019.18853