Published: 2017-06-24

Clinical correlation between dry eye and pterygium: a study done at government medical college Jammu, Jammu and Kashmir, North India

Angli Manhas, Dinesh Gupta, Aditi Gupta, Dinesh Kumar, Rameshwar S. Manhas, Gaurav S. Manhas


Background: To study the prevalence of dry eye among the patients of pterygium and to find the clinical correlation between dry eye and pterygium.

Methods: The study was conducted at postgraduate department of Ophthalmology of GMC Jammu over a period of one year. 90 pterygium patients and 180 age and sex matched controls presenting to the eye OPD of GMC Jammu were included in the study. The TBUT, Schirmer’s test, basal tear secretion and Rose Bengal staining score were estimated in all patients. A TBUT of less than 10 seconds, a Schirmer’s test of less than 10mm, basal tear secretion of less than 10mm, Rose Bengal staining score of more than 3 were considered abnormal.

Results: Redness 57 (63.33%) was the most frequently occurring symptom in pterygium patients followed by cosmosis 49 (54.44%). The mean TBUT, mean Schirmer’s, mean basal secretion and mean Rose Bengal staining score values were 9.88±3.39 seconds, 13.17±4.57mm, 10.11±4.81mm and 3.27±1.85 in pterygium patients and 14.22±3.99 seconds, 16.40±5.21mm, 12.19±5.05mm and 2.49±1.86 in the control group respectively. There was a statistically significant difference in the dry eye results between the pterygium patients and control groups (p<0.001). The odd’s ratio between dry eye and pterygium was 3.83, dry eye was present in 53 pterygium patients.

Conclusions: The prevalence of dry eye in pterygium patients was 58.89% which suggests that there is a strong positive clinical correlation between dry eye and pterygium.


Dry eye, Pterygium, Schirmer test, Tear secretion, Tear film instability, Tear film break up time

Full Text:



Sihota R, Tandon R. Diseases of the conjunctiva. In: Parson’s diseases of the eye. 21st ed. Sihota R, Tandon R. India; Elsevier. 2011:181.

Paton D. Pterygium management based upon a theory of pathogenesis. Trans Am Acad Ophthalmol Otolaryngol. 1975;79:603.

Lu P, Chen XM. Prevalence and risk factors of pterygium. Int J Ophthalmol. 2009;2(1):82-5.

Roka N, Shrestha SP. Assessment of tear secretion and tear film instability in cases with pterygium and normal subjects. Nepal J Ophthalmol. 2013;5(9):16-23.

Lemp MA, Sullivan BD, Crews LA. Biomarkers in Dry Eye Disease. Eur Ophthal Rev. 2012;6(3):157-63.

Stevenson W, Chauhan SK, Dana R. Dry eye disease-an immune mediated ocular surface disorder. Arch Ophthalmol. 2012;130(1):90-100.

Gulati A, Sullivan R, Buring JE, Sullivan DA, Dana R, Schaumberg DA. Validation and repeatability of a short questionnaire for dry eye syndrome. Am J Ophthalmol. 2006;142(1):125-31.

Lee AJ, Lee J, Saw SM, Gazzard G, Koh D, Widjaja D, et al. Prevalence and risk factors associated with dry eye symptoms: a population based study in Indonesia. Br J Ophthalmol. 2002;86:1347-51.

Saleem M, Muhammad L, Islam ZU. Pterygium and dry eye-a clinical study. JPMI. 2004;18(4):558-62.

Balogun MM, Ashaye AO, Ajayi BGK, Osuntokun OO. Tear break-up in eyes with pterygia and pingueculae in Ibadan.WAJM. 2005;24(2):162-6.

Ganeshpuri AS, Kamble BS, Patil P, Wadgaonkar SP. A comparative study of tear film stability and secretion in pterygium patients - Diabetic vs. non-diabetic. Int J of Health Sci Res. 2014;4(4):86-97.

Rajab AY. Evaluation of tear film stability in pterygium and pingueculae. Ann Coll Med Mosul. 2013;39(2):132-5.

Rajiv, Mithal S, Sood AK. Pterygium and dry eye-A clinical correlation. Indian J Ophthalmol. 1991;39(1):15-6.

Moreno JC, Garcia VG, Garcia L. Evaluation of tear film in patients with Pterygium. Eur J Ophthalmol. 2011;00(00).

Wang S, Jiang B, Gu Y. Changes of tear film function after pterygium operation. Ophthalmic Res. 2011;45(4):210-5.

El-Sersy TH. Role of pterygium in ocular dryness. J Egypt Ophthalmol Soc. 2014;107(4):205-08.

Ishioka M, Shimmura S, Yagi Y, Tsubota K. Pterygium and dry eye. Ophthalmologica. 2001;215(3):209-11.

Chaidaroon W, Pongmoragot N. Basic tear secretion measurement in pterygium. J Med Assoc Thailand 2003;86(4):348-52.

Oh HJ, Park YG, Yoon KC. Changes of ocular surface and tear film in patients with pinguecula and pterygium. J Korean Ophthalmol Soc. 2006;47(5):717-24.

Khoo J, Saw SM, Banerjee K, Chia SE, Tan D. Outdoor work and the risk of pterygia: a case control study. Int Ophthalmol. 1998;22(5):293-8.

Lu P, Chen X, Kang Y, Ke L, Wei X, Zhang W. Pterygium in Tibetans: a population-based study in China. Clin Experiment Ophthalmol. 2007;35(9):828-3.

Goldberg L, David R. Pterygium and its relationship to the dry eye in the Bantu. Br J Ophthalmol. 1976;60:720-1.

Lekhanont K, Rojanaporn D, Chuck RS, Vongthongsri A. Prevalence of dry eye in Bangkok, Thailand. Cornea. 2006;25(10):1162-7.

Li M, Zhang M, Lin Y, Xiao Q, Zhu X, Song S, et al. Tear function and goblet cell density after pterygium excision. Eye. 2007;21:224-8.

Lu J, Wang Z, Lu P, Chen X, Zhang W, Shi K, et al. Pterygium in an aged Mongolian population: a population-based study in China. Eye. 2009;23:421-27.

Anguria P, Ntuli S, Carmichael T. Relationships of heredity and dry eye with pterygia in black African patients. SAMJ. 2011;101(2):110.