(But nobody seems to care)
Lawrence Hirst |
Northern Australia is rife with pterygium, the conjunctival disorder that’s seen primarily in tropical and some subtropical regions of the world (Box 1). It’s characterized by a non-malignant, slow-growing proliferation of fibrovascular tissue over the cornea, and the disease processes involve a fibrovascular reaction, chronic inflammatory cell infiltration, angiogenesis, and fibroblastic proliferation and invasion (1). But if you needed to choose a single word to describe it, you probably wouldn’t choose ‘pretty’ (Figure 1). In Brisbane, Queensland, where I was born, raised (and went to medical school), almost every ophthalmologist removes them as a routine part of their practice. They consider it to be a trivial disease and want to perform the simplest surgery to get rid of it. During my undergraduate days back in the late 1960s, most people just scraped it off in the office and sent the patient off for radiotherapy to prevent recurrence.
I left Brisbane in 1973 and travelled 1,000 miles south to work in Melbourne, which was followed by stints in the US: Baltimore in 1976, then St Louis, Missouri in 1983. I saw hardly any cases during my travels away from home. But in 1986, I returned to the Princess Alexander Hospital in Brisbane and was faced, once again, with many cases of terrible pterygium.
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