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Epidemiology and Associated Morbidity of Pterygium: A Large, Community-Based Case-Control Study
Abstract and Figures
Background:
To evaluate the prevalence and risk factors of various conditions among patients with pterygium.
Methods:
A retrospective observational case control study of 4,037 patients who were diagnosed with pterygium in the Central District of Clalit Health Services in Israel from 2000-2009. A total of 16,054 randomly selected controls from the district HMO members. Personal, medical, and demographic information were extracted from patients' files. We calculated the prevalence of various ocular, systemic, and demographic conditions as risk factors for pterygium.
Results:
The average age of pterygium patients was 58.4 ± 14 years; 56.9% were male. A significant tendency to develop pterygium was found among individuals of lower socioeconomic status (p < 0.001) and in populations living in rural areas (p < 0.001). A logistic regression model adjusted to marital status, socio-economic class, and area of living was performed. The following conditions were significantly associated with pterygium: blepharitis (OR = 1.71; 99.9% CI: 1.53-1.93), chalazia (OR = 1.46; 99.9% CI: (1.19-1.78)), anxiety (OR = 1.14, 99.9% CI: 0.98-1.33), and G6PD deficiency (OR = 1.85; 99.9% CI: 1.11-3.07). Schizophrenia (OR 0.31; 99.9% CI: 0.19-0.50) and smoking (OR 0.82; 99.9% CI: 0.76-0.89) were significantly less prevalent among pterygium patients.
Conclusions:
Pterygium etiology is multifactorial. Some demographic, systemic, and periocular conditions are significantly more prevalent and some are less prevalent among pterygium patients. Better understanding of the pathophysiological association between those diseases and pterygium may help in its prevention and treatment.
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... Many studies done in different areas of the world indicated that exposure to ultraviolet radiation, geographical latitude near to the equator, outdoor activity [19], aging, male gender [20], and dusty environment are possible risk factors of pterygium [7,11,21]. As ultraviolet radiation is the major risk factor to pterygium [2,9] wearing sunglasses with UV protective lens and brimmed hats are recommended [9,11]. ...
... Pterygium COR (95% CI) AOR (95% CI) different geographical areas nearer to the equator (tropical area) have greater exposure to ultraviolet-B that intern contributes to the occurrence of pterygium [12,19]. The proportion of pterygium in this study is similar to other studies done in Southwest, Japan (30.8%) [12], China (33.98%) [39]. ...
... On the other side, the proportion of pterygium in this study is lower than other studies done in Northwest Ethiopia (38.7%) [8]. This might due to geographical, latitudinal, economic, and environmental variations that contribute to the occurrence of the disease [19,23]. The other possible reason could due to the age groups included in the studies. ...
Introduction:
A pterygium is a wing-shaped fibro-vascular growth of conjunctiva on the superficial cornea/conjunctiva. It is an elastotic degeneration of conjunctival stroma mainly due to Ultraviolet light exposure. The prevalence of pterygium varies in different environmental conditions. Its magnitude varies widely from 1.1% to 53% globally and in Ethiopia, it reaches from 8.8% to 38.7%.
Objective:
To determine the prevalence of pterygium and its associated factors among adults aged 18 years and above in Gambella town, Southwest Ethiopia, 2019.
Methods and materials:
A community based cross-sectional study was conducted from April 15 to May 3, 2019, in Gambella town. A total of 402 study participants were selected using a systematic random sampling technique. A pre-tested semi-structured questionnaire, torch, and magnifying loops were used to collect data. The data was entered into epidemiological information 7.1 and exported to statistical package for social science version 20 for analysis. The binary and multivariate logistic regression analysis model was fitted to identify factors associated with pterygium. Odds ratio with respected 95% CI was used to identify the direction and strength of association.
Results:
A total of 400 participants were examined with a response rate of 99.50%. The mean age of the study participants was 39.9±9.8years. The prevalence of pterygium among adults aged 18 years and above in Gambella town was 127(31.80%), (95% CI: 27.3, 36.3). male sex (AOR = 2.10 (95% CI: 1.26, 3.45), sunlight exposure (AOR = 6.86 (95% CI: 4.00, 11.79) and outdoor works (AOR = 2.10 (95% CI: 1.21, 3.60) were positively associated with pterygium whereas wearing sunglass/hat was a protective factor.
Conclusion:
The prevalence of pterygium was high among adults living in Gambella town. Wearing sunglass/hat and reducing exposure time to the sun was important to reduce the development of pterygium in adults.
... 7,15,24 The exposure to environmental factors is also higher in Africa, including Ethiopia but the evidence is scarce on the prevalence of pterygium in this region. 13,[25][26][27][28][29] Therefore, this study aimed to determine the prevalence and associated factors of pterygium among adults in Kolla Diba town. The result of this study will be important for planning and implementing health care services and also act as baseline data for further studies. ...
... As previous studies described as low economic status had positively associated with the prevalence of pterygium. 11,26,28,33,34 Another reason might be an age cut off point as the present study involved all available inhabitants aged ≥18 years as compared to the study conducted in Gondar city (age >20 years). In contrast to few other studies, this study also shows lower prevalence than other studies conducted in Ghana 31.0%, ...
... In many works of literature marital status had no direct association with pterygium. 2,13,28 But here in this study being widowed, had a positive association with pterygium. The reason may be due to aging since in this study widowed participants were older in age, despite still in debate, many authors revealed that pterygium is a degenerative (aging) disorder of the conjunctival tissue that leads to vascular proliferation. ...
Background:
Pterygium is a disfiguring disease that can potentially lead to blindness. It is more common in warm, windy and dry climates of tropical and sub-tropical regions of Africa. Globally, the prevalence ranging from 0.07% to 53%. Studies conducted on the prevalence of pterygium in developing countries were limited with a wider discrepancy between them. In this study, we aimed to assess the prevalence of pterygium and its associated factors among adults in Kolla Diba town.
Methods:
A community-based cross-sectional study was done in Kolla Diba town from May 30-June 16, 2019. A systematic random sampling technique was used to select 627 study participants. The basic ophthalmic examination was performed using portable slit lamp, 3x magnifying loop with torch light and a pretested structured questionnaire was completed. The data entered into EPI INFO version 7 and analyzed using SPSS version 20. Descriptive statistics and binary logistic regression analysis were employed. P-values of <0.05 were considered statistically significant.
Results:
A total of 605 study participants were involved with a response rate of 96.5%. Among them, 317 (52.4%) participants were males. The mean age of the respondents was 38.18 ± 15.56 with a range of (18-95) in years. The overall prevalence of pterygium was 112 (18.5% (95% CI (15.6-21.7)). Being widowed (AOR = 7.32 (95% CI: 2.88, 18.57)), outdoor occupation (AOR = 2.50 (95% CI: 1.46, 4.29)), sun exposure (AOR = 2.38 (95% CI: 1.28, 4.43)), wind exposure (AOR = 1.97 (95% CI: 1.04, 3.72)), alcohol drinking (AOR = 2.26 (95% CI: 1.48, 4.63)), and severe blepharitis (AOR = 2.45 (95% CI: 1.48, 4.05)) had statistically significant positive association with pterygium.
Conclusion:
The prevalence of pterygium was relatively higher. Being widowed, outdoor occupation, sun exposure, wind exposure, alcohol drinking, and severe blepharitis were significantly associated with the development of pterygium.
... Starting from 1% in Japan to 26% in the Samoan Islands, as well as an incidence above 33% elder (e" 50 years) in Asia. 4,5 Based on the Basic Health Research Indonesia in 2013, the prevalence rate of pterygium in Indonesia was 8.3%, of which the highest in Bali was 25.2%. 6 Etiology and pathogenesis of pterygium is unclear. ...
... 5 Study in the Central India by Nangia et al (2013) found the mean age of subjects with pterygium 56.6 ± 13 years and age range of 30-85 years. 2 Nemet et al (2014) in Israel stated the mean age of pterygium patients was 58.4 ± 14 years. 4 Total of 28 subjects were included in this study with an average age of 54.21 ± 7.81 years and an age range of 42-70 years. Age as a significant risk factor for pterygium is associated with increased susceptibility to UV exposure in older people with increasing age and spending most of the outdoor activities resulting in accumulation of UV damage. ...
... The tropical climate as a risk factor for pterygium is strongly associated with outdoor activity and UV exposure. 4 Research in Indonesia has a higher prevalence of pterygium in groups with outdoor activity 10 years earlier. 22 Study in Sumatra (Indonesia) by Gazzard et al found a history of outdoor activities > 5 hours / day for the past 10 years associated with doubled risk for pterygium compared without the history. ...
Pterygium is an eye disease with multifactorial etiopathogenesis. Molecular factors such as cell proliferation and inflammatory mediators are associated with increased calcium mobilization and activation of nuclear factor kβ mediated by histamine-1 receptors (H1R). This study aims to determine whether the expression of H1R primary pterygium tissue is higher than normal conjunctival tissue and the expression of H1R based on pterygium grades. This study was an analytic observational study with a case-control study approach at Sanglah General Hospital, Bali Mandara Eye Hospital, and Mangusada Hospital. The study was conducted from November 2017 to April 2018. The pterygium and conjunctival tissues obtained from 28 subjects in the same eye and examined for H1R expression by immunohistochemistry. The results of this study obtained 64.3% of women with a mean age of 54.2 ± 7.8 years. There was no difference in mean H1R expression between pterygium grades in the final score (P = 0.759). There was a mean difference of H1R between primary pterygium (42.50) and normal conjunctival tissue (14.50) with P <0.001. Only tissue types affected the expression of H1R in the final score (B = 4.893; 95% CI 4.363-5.423; P <0.001). It was concluded that the expression of H1R primary pterygium tissue was higher in primary pterygium than normal conjunctival tissue.
... [9][10][11] Known risk factors for pterygium include residency in rural areas, dust exposure, low income, and older age. [12][13][14][15] Interestingly, smoking has been found to be a protective factor. 15,16 Evidence of a clinical association between periocular and systemic inflammatory and immunological diseases and pterygium is currently limited. ...
... 10,11 Rural residence and low socioeconomic status are well-known risk factors for pterygium; primarily explained by higher exposure to UV-b radiation. [12][13][14] Our study supports these findings, as the control group consisted of individuals with a higher socioeconomic status than the group with pterygium, and a greater proportion of individuals in the pterygium group resided in rural areas. Our findings suggest that a family history of pterygium, specifically a parental history, is a significant risk factor for the development of pterygium, as previously reported. ...
Purpose:
To evaluate risk factors for pterygium and prevalence of periocular and systemic diseases among patients with pterygium.
Methods:
A retrospective case-control study was conducted among members of Clalit Health Services (CHS) in Israel, from 2001 to 2022. A total of 13,944 patients diagnosed with pterygium were included. For each case, three controls were matched among all CHS patients according to year of birth, sex, and ethnicity. Mixed models were used to assess differences in demographic characteristics, ocular and systemic diseases between the groups. Generalized estimating equation (GEE) logistic regression was used to estimate the odds ratios (OR) and adjust for confounders.
Results:
The average age of pterygium patients was 49 ± 17 years; 51% were male. The results showed significant associations between pterygium and risk factors of vernal kerato-conjunctivitis (OR 2.52, 95% confidence interval [CI]: [1.96-3.24]), chronic allergic conjunctivitis (OR 1.98, 95% CI: [1.65-2.39]), blepharitis (OR 1.91, 95% CI: [1.78-2.04]), chalazion (OR 1.47, 95% CI: [1.30-1.67]) and unspecified systemic allergy (OR 1.21, 95% CI [1.09-1.34]), after adjusting for rural residency status. Glaucoma (OR 0.74, 95% CI [0.64-0.85]) and smoking (OR 0.70, 95% CI [0.66-0.75]) were protective factors against pterygium.
Conclusion:
Systemic and periocular inflammatory and allergic diseases are risk factors for pterygium.
... It affects up to 5% of the global population and can impact vision through induced astigmatism or encroachment on the visual axis. Pterygia also tend to recur after surgical excision in 30-60% of cases [2,3]. The pathogenesis of pterygium is multifactorial, involving genetic predisposition, chronic UV light exposure, oxidative stress, and settings, including cancer, neurodegenerative diseases, and ocular disorders. ...
Background
Pterygium, characterized by the abnormal proliferation of epithelial cells, matrix remodeling, vascularization, and lesion migration, is a prevalent ocular surface disease involving the growth of fibrovascular tissue on the cornea. Despite the unclear underlying causes of pterygium, numerous investigations have indicated the involvement of cell death pathways in the regulation of cell cycle dynamics. Consequently, the objective of this study was to assess the expression levels of necroptosis markers in individuals diagnosed with pterygium, aiming to shed light on the potential role of necroptosis in the pathogenesis of this condition.
Methods
This study aimed to investigate the expression patterns of receptor-interacting serine/threonine kinase 3 (RIPK3) and receptor-interacting serine/threonine kinase 1 (RIPK1) genes in pterygium tissues. 41 patients undergoing pterygium excision surgery were recruited. Resected pterygium samples and normal conjunctival tissues were collected, and RIPK3 and RIPK1 mRNA levels were measured using quantitative real-time PCR.
Results
Our findings reveal that the expression of RIPK3 is significantly increased in samples obtained from individuals with pterygium. However, no significant alterations were observed in the expression of RIPK1 in these samples. Results showed significantly higher RIPK3 expression in pterygium tissues compared to controls. Moreover, increased RIPK3 levels correlated negatively with pterygium recurrence rates.
Conclusions
These findings suggest RIPK3 may play a protective role against pterygium recurrence through necroptosis.
... Recurrent pterygium occurs mostly in middle-aged and elderly people [12]. Hence, the preious conjunctival autograft, the past or potential trabeculectomy for angle closure glaucoma, dry eye, and some other ocular diseases bring challenges for the pterygium surgery. ...
To observe the effect of micro-conjunctival auto grafting combined with amniotic mem- brane transplantation on the postoperative recurrence, complications and ocular surface symptoms among patients with recurrent pterygium.
... Hence, numerous countries have mentioned pterygium as one of the common chronic eye disease (8) in Asia and other countries located in this belt . One of the (9). determinants of prevalence of pterygium is living in rural areas The risk of pterygium in rural areas is due to lifestyles and environmental conditions and also limited access to health services. ...
To determine the prevalence and occurrence of visual morbidity in patients of pterygium attending eye opd in a tertiary care centre of Bihar. Methods: In this observational study a total of 193 patients, diagnosed with pterygium, underwent complete ocular examination by an ophthalmologist. Epidemiological trends including age, sex, occupation, effect of living condition and socioeconomic status were analyzed. Results: There is a male preponderance of 58.03%. The age incidence of the group showed that the incidence of pterygium was 10.36% in the age group of less than 30 years. It rises to a maximum of 29.53% in the age of 41-50 years and then gradually declines.. The incidence was found to be maximum among farmers(39.86%) followed by miners(31%). Conclusion: People who work outdoors are at a greater risk because they are subjected to involuntary UVB exposure. The highest exposure occurs during the two hours on either side of noon. Workers must be aware and should take appropriate measures like wearing protective glasses, caps, etc
... The association between smoking and pterygium has been controversial. Certain studies have suggested that smoking is a risk factor for pterygium [44], but a metaanalysis in 2014 and a survey in Israel in 2016 showed that smoking had a protective effect [45,46]. The biological impact of smoking on pterygium remains unclear. ...
Background:
To investigate the prevalence of pterygium and associated factors in Han and Mongolian adults at four survey sites in Inner Mongolia, China.
Methods:
We conducted a population-based, cross-sectional study as part of the China National Health Survey (CNHS). By means of a stratified sampling method, we finally included 2651 participants of 30 years of age or older from a total of 3468 eligible residents. Factors associated with pterygium were analysed by a univariate analysis and logistic regression models.
Results:
The study population included 1910 Han and 741 Mongolian adults. The mean age ± standard deviation of the study cohort was 48.93 ± 11.06 years. The overall prevalence of pterygium was 6.4% (n = 169); 1.4% (n = 38) of the cases were bilateral and 4.8% (n = 128) were unilateral. The most common grade of pterygium was Grade 2. Based on the results of the univariate analysis, eleven factors were included in a multivariate analysis. The results indicated that age (P < 0.001), outdoor occupation (P = 0.026), and time spent in rural areas (P < 0.001) were significantly associated with pterygium. Sex and ethnicity were not identified as risk factors.
Conclusions:
Our results indicated that outdoor occupation, old age and more time spent in rural areas were risk factors for pterygium in Inner Mongolia. At the same time, town as a survey site (Hohhot and Tsining District) was a protective factor for pterygium. Ethnicity, gender, smoking, diabetes and high blood pressure are not associated with pterygium.
Background: To investigate the prevalence of and factors associated with pterygium in Han and Mongolian adults at four survey sites in Inner Mongolia, China.
Methods: A population-based, cross-sectional study was conducted. Using a stratified sampling method, we eventually included 2,651 participants of at least30 years of age from a total of 3,468 eligible residents. Factors associated with pterygium were analysed using univariate analysis and logistic regression models.
Results: There were 1,910 Han adults and 741 Mongolian adults included in this study. The mean± standard deviation of age for individuals in the study cohort was 48.93±11.06 years. The overall prevalence of pterygium was 6.4% (n=169), and the prevalences of bilateral and unilateral pterygium were 1.4% (n=38) and 4.8% (n=128), respectively. The most common grade of pterygium was Grade 2. After univariate analysis, eleven factors were considered in a multivariate analysis. The results indicated that age (P<0.001), education level (P<0.001), outdoor occupation (P=0.026), and time spent in rural areas (P<0.001) were significantly associated with pterygium, whereas gender and ethnicity were not risk factors. In subgroup analysis, BMI≥28 was a protective factor for Han individuals (OR 0.42, 95% CI 0.21-0.81, P=0.01), but a risk factor for Mongolian individuals (OR 2.39, 95% CI 1.02-5.58, P=0.044). The BF% in Han and Mongolian individuals had significant difference (P<0.001).
Conclusions: Our results indicated that an outdoor occupation, old age and time spent in rural areas are risk factors for pterygium in Inner Mongolia. Living near an urban survey site (Hohhot and Tsining District) and having a higher education level are protective factors for pterygium. Ethnicity, gender, smoking, diabetes and high blood pressure are not associated with pterygium. Different dietary structures in Han and Mongolian adults may lead to different fat content of body and therefore contributes to the prevalence of pterygium.
Keywords: Pterygium, prevalence, Han and Mongolian, risk factors, protective factors
Background: To investigate the prevalence of pterygium and associated factors in Han and Mongolian adults at four survey sites in Inner Mongolia, China.Methods: We conducted a population-based, cross-sectional study as part of the China National Health Survey (CNHS). By means of a stratified sampling method, we finally included 2,651 participants of 30 years of age or older from a total of 3,468 eligible residents. Factors associated with pterygium were analysed by a univariate analysis and logistic regression models.Results: The study population included 1,910 Han and 741 Mongolian adults. The mean age±standard deviation of the study cohort was 48.93±11.06 years. The overall prevalence of pterygium was 6.4% (n=169); 1.4% (n=38) of the cases were bilateral and 4.8% (n=128) were unilateral. The most common grade of pterygium was Grade 2. Based on the results of the univariate analysis, eleven factors were included in a multivariate analysis. The results indicated that age (P
Glucose-6-phosphate dehydrogenase (G6PD) is an important site of metabolic control in the pentose phosphate pathway (PPP), providing reducing power (NADPH) and pentose phosphates. The purpose of this study was to investigate the possible involvement of G6PD deficiency (G6PD-) in the pathogenesis of pterygium.
Erythrocyte G6PD activity was evaluated in 123 pterygium patients and in 112 age-matched control patients. Enzyme activity, mRNA, rate of growth, green autofluorescence, response to oxidative stress, and cholesterol metabolism were determined in pterygium fibroblasts (PFs) and in normal conjunctival fibroblasts (NCFs) isolated from G6PD normal (NCFs+ and PFs+) and G6PD- (NCFs- and PFs-) patients.
Higher prevalence of G6PD- was found in patients affected by primary pterygium than in control subjects, both men and women, suggesting that this enzymatic defect may be a predisposing factor for pterygium. G6PD activity was significantly lower in NCFs- than in NCFs+, but not in PFs- than in PFs+. In PFs-, G6PD mRNA levels were significantly higher than in PFs+. Growth-stimulated NCFs- grew at half the rate of NCFs+, although PFs- and PFs+ grew at the same rate. Increased green autofluorescence and susceptibility to oxidative stress were observed in PFs (+/-) and in NCFs-, but not in NCFs+. Moreover, ex vivo PFs (+/-) accumulated more lipids than corresponding NCFs.
The results of this study, although restricted to a limited group of subjects (i.e., those of Sardinian ancestry), suggest that G6PD- not only does not protect against pterygium, but may even be considered a risk factor for the development of this disorder.
To determine the prevalence and risk factors for pterygium in the adult Malay population of Singapore.
A population-based survey of Malays aged 40 to 79 years living in Singapore was conducted. Pterygium was diagnosed and graded clinically by slit-lamp examination as Grade 1 (atrophic), Grade 2 (intermediate) and Grade 3 (fleshy). We asked about potential risk factors such as socioeconomic status, cigarette smoking and outdoor activity.
From a total of 4168 eligible subjects, 3280 (78.7%) were examined. There were 508 people with either unilateral (n=289) or bilateral (n=219) pterygium. The overall age-standardised prevalence rate of pterygia was 12.3% (95% CI 11.9% to 12.7%). In multiple logistic regression models, pterygium was independently associated with increasing age (OR, 1.3; 95% CI 1.1 to 1.4), male sex (OR, 1.9; 95% CI 1.5 to 2.6) and high systolic blood pressure (OR, 1.6; 95% CI 1.2 to 2.1). Grade 3 pterygium (n=92) was also associated with cholesterol in the fourth versus the first quartile (p=0.02) and with male sex. Outdoor occupation is only significant for severe pterygium (p=0.03).
The prevalence of pterygium is 12.3% among urban Malays aged 40 years and older and higher than Chinese of similar ages in Singapore. Independent associations of pterygia with increasing age, male sex, outdoor occupations and systemic factors like blood pressure suggest a complex and multi-factorial aetiology for this condition.
Pterygium is a common ocular surface disease characterized by fibrovascular invasion of the cornea and is sight-threatening due to astigmatism, tear film disturbance, or occlusion of the visual axis. However, the mechanisms for formation and post-surgical recurrence of pterygium are not understood, and a valid animal model does not exist. Here, we investigated the possible mechanisms of pterygium pathogenesis and recurrence.
First we performed a genome wide expression analysis (human Affymetrix Genechip, >22000 genes) with principal component analysis and clustering techniques, and validated expression of key molecules with PCR. The controls for this study were the un-involved conjunctival tissue of the same eye obtained during the surgical resection of the lesions. Interesting molecules were further investigated with immunohistochemistry, Western blots, and comparison with tear proteins from pterygium patients.
Principal component analysis in pterygium indicated a signature of matrix-related structural proteins, including fibronectin-1 (both splice-forms), collagen-1A2, keratin-12 and small proline rich protein-1. Immunofluorescence showed strong expression of keratin-6A in all layers, especially the superficial layers, of pterygium epithelium, but absent in the control, with up-regulation and nuclear accumulation of the cell adhesion molecule CD24 in the pterygium epithelium. Western blot shows increased protein expression of beta-microseminoprotein, a protein up-regulated in human cutaneous squamous cell carcinoma. Gene products of 22 up-regulated genes in pterygium have also been found by us in human tears using nano-electrospray-liquid chromatography/mass spectrometry after pterygium surgery. Recurrent disease was associated with up-regulation of sialophorin, a negative regulator of cell adhesion, and never in mitosis a-5, known to be involved in cell motility.
Aberrant wound healing is therefore a key process in this disease, and strategies in wound remodeling may be appropriate in halting pterygium or its recurrence. For patients demonstrating a profile of 'recurrence', it may be necessary to manage as a poorer prognostic case and perhaps, more adjunctive treatment after resection of the primary lesion.
Objective
To describe the distribution and risk factors for pterygium in the predominantly black population of the Barbados Eye Study, which was based on a random sample of Barbadian-born citizens between the ages of 40 and 84 years.Methods
The standardized protocol included ophthalmic and other measurements, automated perimetry, lens gradings, fundus photography, and a detailed interview. A 10% systematic sample of participants and those meeting specific criteria also received a comprehensive ophthalmologic evaluation.Results
The Barbados Eye Study included 4709 participants, of whom 2978 were referred for an ophthalmologic evaluation and 2781 (93%) completed the examination. Cases of pterygium were found among 23.4% of 2617 black, 23.7% of 97 mixed(black and white), and 10.2% of 59 white participants examined. In addition to African ancestry, logistic regression analyses indicated a positive association between pterygium and age (odds ratio [OR], 1.01; 95% confidence interval[CI], 1.00-1.02), fewer years of education (OR, 1.43; 95% CI, 1.01-2.03), and an outdoor job location (OR, 1.87; 95% CI, 1.52-2.29). Having a darker skin complexion (OR, 0.66; 95% CI, 0.52-0.83), always using sunglasses outdoors(OR, 0.18; 95% CI, 0.06-0.59), and the use of prescription glasses (OR, 0.75; 95% CI, 0.60-0.93) were protective factors.Conclusions
Approximately one quarter of the black participants examined had pterygia, a frequency that was 2.5 to 3 times higher than among whites in the Barbados Eye Study and elsewhere. Pterygium was almost twice as frequent among persons who worked outdoors but was only one fifth as likely among those who always used sunglasses outdoors. Educational interventions to modify these potential exposures may assist in preventing pterygium.
• The relationship between exposure to sunlight and senile cataract, age-related macular degeneration, pterygium, and climatic droplet keratopathy was examined in 838 watermen who work on the Chesapeake Bay. The presence and severity of lenticular, corneal, and macular changes were assessed by either clinical examination or from stereo macular photographs. From detailed exposure histories, ocular exposure was estimated for three bands of visible radiation—violet (400 to 450 nm), blue (400 to 500 nm), or all visible (400 to 700 nm)—as well as for UV-A (320 to 340 nm) and UV-B (290 to 320 nm). The results with each band of visible radiation were similar. Neither cortical nor nuclear cataract was associated with ocular exposure to blue or all visible radiation, but pterygium and climatic droplet keratopathy were more common with higher exposures. Compared with age-matched controls, patients with advanced age-related macular degeneration (geographic atrophy or disciform scarring) had significantly higher exposure to blue or visible light over the preceding 20 years (odds ratio, 1.36 [1.00 to 1.85]) but were not different in respect to exposure to UV-A or UV-B. These data suggest that high levels of exposure to blue or visible light may cause ocular damage, especially later in life, and may be related to the development of age-related macular degeneration.
Purpose: The purpose of this report is to review the presenting symptoms and signs, treatment regimens used, complications encountered, and outcome in a cohort of patients with ocular rosacea.
To evaluate the prevalence of systemic medical conditions in patients with blepharitis.
A retrospective observational case-control study.
All the members who were diagnosed with blepharitis in the Central District of Clalit Health Services in Israel (years 2000-2009; n=16706) and 16706 age- and gender-matched controls randomly selected from the district members.
Analysis of the prevalence of various ocular and systemic conditions, risk factors, age, gender, marriage status, country of origin, place of residency, and socioeconomic status.
The prevalence of any associated morbidity.
Demographically, a significantly higher tendency to develop blepharitis was found in populations of lower socioeconomic class, populations living in urban areas, and Ashkenazi Jews. A significant association of P<0.001 was found with some inflammatory diseases (gastritis, peptic ulcer, asthma, arthropathy, and ulcerative colitis), psychologic conditions (anxiety, irritable bowel syndrome, neuroses, and depression), hormonal conditions (hypothyroidism and prostatic hypertrophy), cardiovascular diseases (carotid artery disease, hyperlipidemia, hypertension, and ischemic heart disease), and other eye conditions (chalazion, pterygium). The strongest associations found were between blepharitis and chalazia (odds ratio [OR] 4.7; confidence interval [CI], 3.8-5.7), rosacea (OR 3; CI, 2.1-4.3), pterygia (OR 2.0; CI, 1.5-2.6), ulcerative colitis (OR 2.3; CI, 1.2-4.2), irritable bowel syndrome (OR 1.8; CI, 1.3-2.5), anxiety (OR 1.6; CI, 1.4-1.9), and gastritis (OR 1.6; CI, 1.4-1.7).
Some ocular and systemic conditions are more prevalent among patients with blepharitis. Better understanding of the pathophysiologic association between those diseases and blepharitis may help in its treatment and prevention.
The author(s) have no proprietary or commercial interest in any materials discussed in this article.
Pterygium is a common corneal eye condition that can be disfiguring and may require surgery to avoid loss of vision. There are no population-based data on the prevalence or on risk factors among Latinos.
A population-based sample of 4774 self-reported Latinos age > or = 40 years from randomly selected block groups in Nogales and Tucson, Arizona, USA, were enrolled in the study. Questionnaires were conducted in the home on risk factors. A clinical examination by an experienced ophthalmologist was carried out, and the presence of pterygium was diagnosed at the examination.
The prevalence of pterygium was high (overall 16%). Men had a higher rate than women (23.7% versus 11.5%, respectively). Low income and low educational status were associated with higher odds of pterygium. Current smoking, and smoking dose, was protective for pterygium; this finding has now been reported from several studies.
Pterygium rates were high in this population of Latinos. Socioeconomic status markers for increased exposure to sunlight suggest this may be the target of simple interventions to reduce the risk of pterygium in this ethnic population.
A comparative study was performed on two groups of Bantus in Johannesburg to see if there was any relationship between the "dry eye" and pterygia, but no correlation was found.
The relationship between exposure to sunlight and senile cataract, age-related macular degeneration, pterygium, and climatic droplet keratopathy was examined in 838 watermen who work on the Chesapeake Bay. The presence and severity of lenticular, corneal, and macular changes were assessed by either clinical examination or from stereo macular photographs. From detailed exposure histories, ocular exposure was estimated for three bands of visible radiation-violet (400 to 450 nm), blue (400 to 500 nm), or all visible (400 to 700 nm)-as well as for UV-A (320 to 340 nm) and UV-B (290 to 320 nm). The results with each band of visible radiation were similar. Neither cortical nor nuclear cataract was associated with ocular exposure to blue or all visible radiation, but pterygium and climatic droplet keratopathy were more common with higher exposures. Compared with age-matched controls, patients with advanced age-related macular degeneration (geographic atrophy or disciform scarring) had significantly higher exposure to blue or visible light over the preceding 20 years (odds ratio, 1.36 [1.00 to 1.85]) but were not different in respect to exposure to UV-A or UV-B. These data suggest that high levels of exposure to blue or visible light may cause ocular damage, especially later in life, and may be related to the development of age-related macular degeneration.