Aim To report the outcome of pterygium surgery performed at a tertiary eye care centre in South India. Methods Retrospective analysis of medical records of 920 patients (989 eyes) with primary and recurrent pterygia operated between January 1988 and December 2001. The demographic variables, surgical technique (bare sclera, primary closure, amniotic membrane transplantation (AMT), conjunctival autograft (CAG), conjunctivallimbal autograft (CLAG), or surgical adjuvants), recurrences and postoperative complications were analysed. Results A total of 496 (53.9%) were male and 69 (7.5%) had bilateral pterygia. Bare sclera technique was performed in 267 (27.0%) eyes, primary conjunctival closure in 32 (3.2%), AMG in 123 (12.4%), CAG in 429 (43.4%), and CLAG in 70 (7.1%). Adjuvant mitomycin C was used in 44 (4.4%) cases. The mean duration of follow-up was 8.9717.0 and 5.978.8 months for unilateral primary and recurrent pterygia, respectively. The overall recurrence rate was 178 (18.0%). Following primary and recurrent unilateral pterygium excision respectively, recurrences were noted in 46 (19.4%) and 1 (33.3%) eyes after bare sclera technique, five (16.7%) and 0 after primary closure, 28 (26.7%) and 0 with AMG, 42 (12.2%) and five (31.3%) with CAG, and nine (17.3%) and two (40%) with CLAG. Recurrences were significantly more in males with primary (23.3 vs 10.7%, Po0.0001) and recurrent (26.7 vs 0%, P ¼ 0.034) pterygia, and in those below 40 years (25.2 vs 14.8%, P ¼ 0.003). Conclusion CAG appears to be an effective modality for primary and recurrent pterygia. Males and patients below 40 years face greater risk of recurrence. Bare sclera technique has an unacceptably high recurrence. Prospective studies comparing CAG, CLAG, and AMG for primary and recurrent pterygia are needed.

Whereas anatomic success of pediatric keratoplasty is increasing, optical success continues to remain less than satisfactory. Early surgical intervention and intensive amblyopia therapy may promote visual recovery.

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Differentiating a contact lens-induced peripheral ulcer (CLPU) from early stage microbial keratitis (MK) is primarily based on clinical judgment rather than on microbiologic or histopathologic investigations. For this reason, tests do not provide valuable information at the early stages in the clinical course of MK. Whereas in gross terms, the clinical picture of MK is more acute and severe than CLPU, clinical features of the two can overlap, sometimes resulting in errors of judgment and mismanagement. This article provides clinical clues that help distinguish the two conditions. In addition, a scoring system has been devised for MK and CLPU. Microbial keratitis (MK) is a dreaded complication for contact lens wearers. Although the risk is small, the large population of contact lens (CL) users have made CL wear a major predisposing factor for corneal infection. The reported incidence of MK among CL wearers may be inaccurate because it can be easily confused with its sterile counter part, contact lens-induced peripheral ulcer (CLPU). An accurate initial clinical impression is critical in avoiding mismanagement of these conditions. Clinical differentiation between infected and sterile corneal infiltrates in CL wearers has been addressed in the literature. We suggest a scheme for distinguishing early stage MK from CLPU.