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The risk factors of pterygium: a systematic review and meta-analysis

Poster Details

First Author: S.Serghiou UK

Co Author(s):    P. Koay              

Abstract Details


Produce a central database for the risk factors of pterygium and provide quantitative synthesis of their effect sizes.


University of Edinburgh


We performed a systematic literature search for observational studies of any language or publication type, using PubMed, EMBASE, ISI Web of Science and the Cochrane Central Register of Controlled Clinical Trials (CENTRAL) from 1900 to November 2013. Only observational studies employing multivariate regression analysis and random sampling were considered. Detailed risk of bias assessment was based on previously published guidelines.


Our results suggest that the statistically significant risk factors for pterygium are: rural area of residence [Odds Ratio (OR), 2.79; 95% Confidence Interval (CI), 1.58-4.90), high cumulative sunlight exposure [OR, 2.31; 95% CI, 1.29-4.14], lower level of education [OR 2.25; 95% CI 1.45-3.49], outdoor or manual occupation [OR 1.52; 95% CI 1.30-1.78], low income [OR 1.38; 95% CI 1.14-1.68], male gender [OR 1.35; 95% CI 1.09-1.67] and dry eye symptoms [OR 1.29; 95% CI 1.13-1.48]. The association of age to pterygium prevalence appears to be the product of disease accumulation. Only the use of spectacles was a statistically significantly protective factor. Factors without any statistically significant effect on pterygium prevalence were: darker iris colour, alcohol consumption, hypertension, diabetes mellitus and smoking. Factors for which we did not possess adequate studies to perform a robust meta-analysis have been collected to provide a comprehensive database of every risk factor ever studied in association to pterygium. The pooled estimates for all significantly associated factors apart from dry eye symptoms and use of spectacles featured very high heterogeneity, indicating that these effect sizes should be used only as an indication of the true effect size.


Pterygium prevalence increases with all factors associated to sunlight, dust particles and dry eyes. We propose an updated theory to explain our results. FINANCIAL INTEREST: NONE

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