missed a pterygium?

I had conjunctival autograph surgery this April, 2008 for the first time.  This is my second surgery on this eye because it grew back.  As far as I could see there was only 1 pterygium on my eye. It has been 4 months since the removal, but now I see that I have two  in the very left corner of my eye.  I have to turn my gaze to the right to even see it.  I'm thinking that it was missed on the original exam.  On follow-up,my doctor said my pterygium(s) came back.  And now he wants to refer me to a new doc in his practice who specializes in a particular kind of surgery involving "amniotic fluid" to  remove my pterygiums.  What I think really happened was that my doc actually missed these two pterygiums and only operated on the visiblie one.   Is it possible that these are new pterygiums so soon after the surgery?  Lydge

[John C Hagan III, MD, FACS, FAAO]

Given that the eye is examined with instruments that magnify the eye 10-20 times I don't think it was "over looked". Moreover its highly unlikey that as often as you look in your mirror at yourself that you would not have seen it.

It's "auto-grafts" not autographs.

Re Excision with amniotic membrane graft would  be the next step.

Re occurence is the #1 problem with ptergyeum surgery and as many as 10-20% reoccur.

JCH MD

[Lydge]

Thanks for your response.    But I'm not clear what you mean to say it's not likely that I would not have seen it.  I actually did not see it until he told me "it had come back" on my last exam.  These are not visible when I look straight into the mirror.  As I said, I have to really turn my head to see them. That eye has remained blood shot and I've been using predforte several times a day.  I will be seeing my doc in the next week and will discuss the amniotic membrane graft with him.  Lydge

[John C Hagan III, MD, FACS, FAAO]

Consider getting a second opinion before you have addiitional surgery.
JCH MD

[Lydge]

Will pursue that.  Thanks, Lydge

[John C Hagan III, MD, FACS, FAAO]

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[Lydge]

I was referred to a new doc in my regular doc's practice for a consult. He did not recommend the auto-graft for my ptyergium.  In fact, he said these growths were more like little blisters due to dry eyes.  He recommended prescription eye drops to manage my dry eyes and said that these blisters could very well resolve themselves .  Lydge

[John C Hagan III, MD, FACS, FAAO]

Good I'm glad your don't need surgery.

JCH MD