title: Evaluating pterygium severity: a survey of corneal specialists.
abstract: OBJECTIVE
  Accurate and reliable evaluation techniques are essential for clinical and epidemiologic studies. This survey of corneal specialists was designed to lay a foundation for the further development of methods for evaluating and staging pterygium.
  
  
  METHODS
  In a self-administered, mailed questionnaire, 213 corneal specialists rated the importance of nine symptoms, nine signs, and nine clinical tests for the severity of primary pterygium. Severity was defined as the present need for surgical intervention.
  
  
  RESULTS
  The most important factors for determining primary pterygium severity were the extent of encroachment onto the cornea, decreased visual acuity, restricted ocular motility, and increased rate of growth. Many patient symptoms were rated as moderately to highly important. The questionnaire was shown to have good response reliability by test-retest comparisons. Cronbach's alpha was 0.89, which indicates very good internal consistency reliability.
  
  
  CONCLUSIONS
  The survey identifies the priorities of experts in determining the severity of pterygium. More precise and clearly defined evaluation methods will enhance future clinical and epidemiologic studies of pterygium. The ranked list of pterygium signs, symptoms, and tests can serve as a guide for developing pterygium evaluation methods in the future. There is a need for a method that accurately and precisely quantifies the distance of pterygium encroachment onto the cornea and the pterygium progression rate. Furthermore, there is a need for an assessment of patient symptoms.
authors.affiliation: School of Optometry, University of California, Berkeley 94720-2020, USA. twelker@uclink4.berkeley.edu
authors.forename: J D
authors.initials: JD
authors.lastname: Twelker
authors.forename: I L
authors.initials: IL
authors.lastname: Bailey
authors.forename: M J
authors.initials: MJ
authors.lastname: Mannis
authors.forename: W A
authors.initials: WA
authors.lastname: Satariano
mesh_terms: D006306:Health Surveys; D006801:Humans; D009885:Ophthalmology / Q000706:statistics & numerical data*; D010818:Practice Patterns, Physicians'; D011625:Pterygium / Q000145:classification / Q000175:diagnosis* / Q000601:surgery; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires