Correlation of pterygium severity with meibomian gland dysfunction and ocular surface alterations in unilateral cases

The present study aimed to evaluate the effect of unilateral pterygium on corneal topography, tear film characteristics, meibomian gland function, and pupillary dynamics.

A cross-sectional observational analysis was performed with 57 patients who had unilateral primary nasal pterygium and healthy contralateral eyes. Comprehensive ophthalmic evaluation included corneal topography, pupillary measurements, meibography, and tear film assessment. A comparison was made between affected eyes and their unaffected counterparts, and the correlations of pterygium severity with the ocular surface parameters were analyzed.

Significant differences were observed between pterygium-affected and normal eyes. Pterygium eyes showed higher corneal astigmatism (2.5 ± 0.8 D vs. 0.95 ± 0.6 D, respectively, p < 0.001) and higher-order aberrations (0.45 ± 0.12 µm vs. 0.38 ± 0.10 µm, p = 0.02). Furthermore, the baseline pupil diameter was smaller in pterygium eyes (3.8 ± 0.4 mm vs. 4.2 ± 0.5 mm, respectively, p < 0.001), while meibomian gland area loss was greater (32.5 ± 8.4% vs. 15.8 ± 5.6%, p < 0.001) and noninvasive tear breakup time was reduced (5.8 ± 2.1 s vs. 9.4 ± 2.7 s, respectively, p < 0.001). Correlations between pterygium severity and ocular surface metrics were significant, underscoring a dose-dependent relationship.

Pterygium severely affects a wide range of ocular surface parameters that include corneal topography, tear film stability, meibomian gland function, and pupillary dynamics. These results suggest that a comprehensive evaluation of patients with pterygium should be performed to ensure a good quality of life.