Management of Irregular Astigmatism Secondary to Pterygium Removal with the Use of Scleral Contact Lenses

A pterygium is a common ocular surface disorder. Management techniques have been dated back to 1000 B.C., from bile and urine to anti-VEGF injections. Unfortunately, pterygia lead to an irregular surface causing unwanted side effects, such as poor cosmesis, decreased visual acuity (VA), disruption of the tear film and foreign body sensation. Current management strategies for pterygia involve surgical excision, which improves the condition of the ocular surface but does not resolve the irregular astigmatism. This case report outlines a discussion of a patient with a history of bilateral, nasal pterygium removal that had remaining irregular astigmatism decreasing the quality of vision. It reviews the successful fitting of a scleral gas permeable contact lens, leading to an improvement in visual acuity, contrast, and ocular comfort.