When circumcorneal conjunctival hyperemia, or ciliary flush, is noted on physical examination of a patient, which of the following is the most likely diagnosis?

Acute glaucoma
Adult inclusion conjunctivitis
Bacterial conjunctivitis
Cataract

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By

Melvin I. Roat

, MD, FACS, Sidney Kimmel Medical College at Thomas Jefferson University

Last full review/revision Oct 2019| Content last modified Oct 2019

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NOTE: This is the Professional Version. CONSUMERS: Click here for the Consumer Version

Topic Resources

Pinguecula

Pterygium

Pinguecula and pterygium

Pinguecula and pterygium are benign growths of the conjunctiva that can result from chronic actinic irritation. Both typically appear adjacent to the cornea at the 3-o’clock position, the 9-o’clock position, or both.

A pinguecula is a raised yellowish white mass within the bulbar conjunctiva, adjacent to the cornea. It does not tend to grow onto the cornea. However, it may cause irritation or cosmetic blemish and, although rarely necessary, can easily be removed.

A pterygium is a fleshy triangular growth of bulbar conjunctiva that may spread across and distort the cornea, induce astigmatism, and change the refractive power of the eye. Symptoms may include decreased vision and foreign body sensation. It is more common in sunny, hot, dry climates. To relieve symptoms caused by a pterygium, artificial tears or a short period of treatment with corticosteroid drops or ointments may be prescribed. Removal is often indicated for documented growth, cosmesis, to reduce irritation, and to improve or preserve vision. The technique with the best results to prevent recurrence is surgical removal of the pterygium followed by conjunctival autograft and perhaps with cyclosporine drops.