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The Slip! Slop! Slap! Sunsmart safety campaign was an Australian initiative implemented in the 1980s. To assess this campaign's effect on pterygium, we examined the rate of pterygium surgery across Australia and described the prevalence and associations of pterygium in Perth, Australia's sunniest capital city. The rate of pterygium surgery was examined using Australian Medicare data. A cross-sectional analysis of the Generation 1 (Gen1) cohort of the Raine Study was performed to investigate the prevalence of pterygium in Perth. We investigated the association between pterygium and conjunctival ultraviolet autofluorescence (CUVAF) area, an objective biomarker of sun exposure, and demographics and health variables derived from a detailed questionnaire. Between 1994 and 2017, the rate of Medicare funded pterygium surgery in Western Australia fell 11%, well below the national average decline of 47%. Of the 1049 Gen1 Raine Study participants, 994 (571 females; mean age 56.7 years, range = 40.9–81.7) were included in the analysis. The lifetime prevalence of pterygium was 8.4% (n = 83). A higher prevalence of pterygium was associated with outdoor occupation (p-trend = 0.007), male sex (p-trend 0.01) and increasing CUVAF area (p-value <0.001). The effect of Australia's Slip! Slop! Slap! Sunsmart safety campaign on pterygium been mixed. Since 1994, the rate of private pterygium surgery has declined significantly in all Australian states except Western Australia. Perth, Western Australia, has the highest pterygium prevalence of any mainland-Australian cohort. Higher CUVAF area, male sex, and outdoor occupation were associated with an increased risk of pterygium. [ABSTRACT FROM AUTHOR]

Background: It was the author's (LWH) observation that pterygium was frequently misdiagnosed by general practitioners that led to this study. The aim was to identify the rate of misdiagnosis of pterygium by optometrists and general practitioners based upon assessing referral accuracy to a single ophthalmologist (LWH).Methods: This study involved a prospective case series from 25 March 2015 to 18 December 2018 in a tertiary referral practice specialising in pterygium. The accuracy of diagnosis of pterygium, based upon the content of the clinical referral, was undertaken for optometrists and general practitioners. The benchmark for diagnostic accuracy was the diagnosis made by the author (LWH) during a consultation in person by the author (LWH) using a hand-light examination and confirmed by slitlamp examination.Results: A total of 1,511 consecutive patients were included in the study with 90/549 incorrectly diagnosed (16 per cent) by general practitioners and 14/962 (1.4 per cent) by optometrists. General practitioners were 13.28 times more likely to incorrectly diagnose a pterygium than optometrists (95% CI 7.48-23.57). Almost exclusively, the incorrect diagnosis made by general practitioners was naming a pinguecula, a pterygium. The same misdiagnosis was made by optometrists but far less frequently.Conclusion: General practitioners misdiagnosed pterygium far more often than optometrists which may reflect a reduction in training in eye health. [ABSTRACT FROM AUTHOR]

Importance: Pterygium is a very common disease in Australia but the statistical data on the provision of pterygium surgical services is poorly understood. Background: This study evaluated the trends in the types of surgeries performed for pterygium in Australia over an eight period. Design Retrospective cross‐sectional study. Participants: All surgeries performed for pterygium in Australia from 2005 to 2010 in the Medicare system. Methods: Eight years of Medicare data were analysed for services performed with pterygium removal. Main Outcome Measures: Concurrently used MBS item numbers 42 686 (pterygium removal) with 42 641 (conjunctival autograft) and also 42 686 with any other ophthalmic item number. Results: Pterygium removal was undertaken together with conjunctival autografting in 73% of patients in 2005 rising to 88% in 2010. Five other non‐related surgical procedures were performed simultaneously with pterygium removal in 10% of patients in 2005 decreasing to 5.9% in 2012. Conclusions and Relevance: About 12% of pterygium surgeries are not combined with a conjunctival autograft. It is possible that these may have been used with an adjuvant such as mitomycin or radiotherapy, or performed as simple excision. Allowing for the possibility that billing errors may have occurred it is still likely that in 5.9% of patients, other procedures that would normally not be performed with pterygium surgery, are undertaken simultaneously and may have an adverse outcome on the inappropriate concurrent surgery and on the recurrence rate of the pterygium. The surgeon should carefully review billing codes before submitting them to Medicare. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this report was to describe the number of Australians affected by pterygium in recent years, treatment options, number of treatment encounters and costs of treatment. Method: A review of published literature was conducted to identify the prevalence of pterygium in Australian populations. Costs of primary care were based on national general practitioner (GP) survey data. Costs of surgical intervention were based on Health Insurance Commission claims data and Australian Institute of Health and Welfare National Hospital Morbidity Data. Results: Pterygium occurs in 1.1% of Australians. It is more prevalent in populations with higher exposure to ultraviolet radiation, and older men (occurring in 12% of males over 60 years).The estimated annual number of GP contacts was 58 900. Forty per cent of primary care contacts for pteryglum were referred to an ophthalmologist and topical medication was prescribed by GPs in 32% of contacts. The estimated annual cost of GP visits, specialist visits and topical medication was AUD$3.2 m. There were 6997 claims for pterygium removal in 1999/2000 with 3192 conjunctival autografts. Rates of pterygium removal were highest in Queensland with 56 per 100 000 population.The annual costs of surgical intervention were estimated at AUD$4.8 m. Conclusions: The direct medical costs of pterygium in Australia are AUD$8.3 m annually. This is likely to be an underestimate of total cost because indirect costs such as loss of work time could not be measured. More data are needed on the long-term benefits of pterygium intervention. [ABSTRACT FROM AUTHOR]

A bstract Background: To determine the prevalence of pterygium within the indigenous Australian population living in central Australia. Design: Clinic-based cross-sectional study. Participants: A total of 1884 individuals living in one of 30 remote communities within the statistical local area of 'Central Australia'. This equated to 36% of those aged ≥20 years and 67% of those aged ≥40 years within this district. Methods: Participants aged 20 years or over were recruited as they presented to the eye clinic at each remote community. Slit-lamp examination was performed, and the presence of a pterygium or evidence of previous pterygium surgery was recorded. Main Outcome Measures: The prevalence of a pterygium in one or both eyes is presented. Results: Pterygium was present in one or both eyes of 9.3% of individuals aged 40 years or older. Right and left eyes were affected equally ( χ2 = 0.19; P = 0.91). There was a significant association between the presence of a pterygium and age ( t = 3.99; P < 0.0001). There was no association with gender ( χ2 = 1.06; P = 0.30). Conclusion: Pterygium was present in a significantly higher proportion of indigenous Australians compared with non-indigenous Australians. This is similar to previous findings of the National Trachoma and Eye Health Program and may be due to a difference in proportion of hours spent outdoors and consequent exposure to ultraviolet radiation. [ABSTRACT FROM AUTHOR]

Clinical Relevance: Developing an accurate picture of the demographic profile and refractive status of Aboriginal and non-Aboriginal individuals with pterygium will facilitate health planning and appropriate deployment of health-care resources in rural Australia., Background: To date, there is a paucity of reports in the literature regarding Aboriginal ocular health and refractive error. This study examines clinical data from a rural ophthalmology outreach clinic - a predominantly Aboriginal population., Methods: An assessment was undertaken of data of 293 patients noted to have pterygium present in at least one eye, from a sample of 2,072 individuals seen in rural northern Western Australia in 2017 by the Lions Outback Vision Visiting Optometry Service., Results: Pterygium was found in 14.1 per cent (n = 293) of patients using the Lions Outback Vision service. The mean age of those with pterygium (n = 293) was 57.1 ± 11.9-years (mean ± standard deviation); 188 were female (64.1 per cent); 260 identified as Aboriginal (88.7 per cent), 22 identified as non-Aboriginal (7.5 per cent) and 11 did not specify (3.8 per cent). There were more males than females with pterygium in the non-Aboriginal group (18.0 per cent versus 6.4 per cent); however, the reverse was true in the Aboriginal group (11.7 per cent versus 17.0 per cent). Analysis of the subjective refractive data in those with pterygium revealed an overall mean spherical equivalent value of +0.66 ± 1.28 DS. The median (interquartile range) best-corrected visual acuity was 0.0 (-0.1 to 0.0) logMAR (6/6 Snellen equivalent)., Conclusions: This paper increases our knowledge of ocular health in a remote Australian population, with an emphasis on the differences between Aboriginal and non-Aboriginal individuals, males and females.