Date amended:
Statements of Principles

Current RMA Instruments:

Reasonable Hypothesis SOP
116 of 2015
Balance of Probabilities SOP
117 of 2015
Changes from previous instruments:


ICD Coding:
  • ICD-9-CM Codes: 372.4
  • ICD-10-AM Codes: H11.0
Brief description

A pterygium is a benign growth on the conjunctiva of the eye, usually on the nasal side.

Confirming the diagnosis

The diagnosis is made on clinical grounds, based on the typical appearance and location of the lesion.

The relevant medical specialist is an ophthalmologist. 

Additional diagnoses covered by the SOPs
  • Nil
Conditions not covered by these SOPs
  • Pinguecula*
  • Pseudopterygium#, ICD code 372.52

SOP condition*

nonSOP condition#

Clinical onset

Clinical onset will generally correspond with date of diagnosis.  Backdating may be possible if there have been continuous chronic symptoms prior to diagnosis such as the sensation of a foreign body in the eye, tearing, dryness and itchiness of the eye.

Clinical worsening

The SOP has only an inability to obtain appropriate clinical management factor for worsening.  The condition may progress over time and interfere with vision.  Surgical treatment may be effective, although the condition may recur.