Limbal Niche dysfunction in pterygium: An integrated review of pathophysiology and clinical advances

Pterygium is increasingly recognised as a localized manifestation of limbal stem cell deficiency (LSCD), rather than a purely degenerative lesion. This review synthesizes recent findings on the pathophysiological mechanisms underlying pterygium - particularly its links to UV-induced damage, epithelial-mesenchymal transition, and chronic inflammation - through the lens of limbal niche disruption. Histopathological and immunological evidence is complemented by advanced imaging modalities such as optical coherence tomography and in vivo confocal microscopy, which offer unprecedented insights into limbal architecture. Finally, the review under discussion here highlights emerging surgical paradigms, with a particular emphasis on limbal-conjunctival autografting as a means of reducing recurrence and restoring epithelial homeostasis. A more profound comprehension of limbal dynamics in pterygium has the potential to inform future diagnostic and regenerative interventions in ocular surface disease.