Relationship of Environmental Exposure with Clinical Morphology of Primary Pterygium in Pakistani Adults.

Original Article

Abstract

Objective: To determine the association of age, sex, daily sun exposure, smoking, and toxic chemical exposure with the clinical morphology of primary pterygium.

Methodology: This cross-sectional study was conducted in the Department of Anatomy, Shifa College of Medicine, Rawalpindi, from January 2025 to December 2025. Forty-one patients had primary unilateral pterygium. We recorded average daily sun exposure from the clinical history as hours per day. Smoking was recorded only as a categorical smoking-status variable. We recorded toxic chemical exposure only as present or absent. We examined the pterygium for visible inflammation, atrophic or progressive appearance, Stocker's line, Fuchs spots, corneal extension, and site.

Results: The mean age was 52.15 ± 14.36 years and 24 patients (58.5%) were female. Mean daily sun exposure was 5.54 ± 1.00 hours. Fifteen patients (36.6%) were smokers, and 27 (65.9%) reported toxic chemical exposure. Clinical inflammation occurred in 41.5%, progressive pterygium in 24.4%, Stocker’s line in 36.6%, and Fuchs spots in 22.0%. We found no clear associations between the examined factors and clinical features. Continuous estimates were small and imprecise, while categorical comparisons included confidence intervals.

Conclusion: Among 41 surgically selected patients with unilateral primary pterygium, we found no clear associations between demographic or environmental factors and lesion morphology. Smaller associations cannot be excluded, and findings should not be generalized beyond this selected population.