Pterygium

The clinical image above depicts an ocular condition being managed surgically. Which of the following is the most likely diagnosis?

A 52-year-old male farmer from rural Rajasthan presents with a 3-year history of progressive blurring of vision in both eyes. On examination, he has a fleshy, triangular vascularized growth encroaching onto the cornea from the nasal side bilaterally. The growth is more advanced on the right eye, where it crosses the limbus and extends 3 mm onto the cornea. Visual acuity is 6/9 in the right eye and 6/6 in the left eye. He reports significant sun exposure throughout his life. What is the most appropriate management for his right eye at this stage?

A 48-year-old man from coastal Tamil Nadu undergoes surgical excision of a left pterygium that had begun to obscure the visual axis. Intraoperatively, the surgeon uses mitomycin C 0.02% for 3 minutes followed by copious irrigation. At 6 weeks post-operative follow-up, the patient develops a clear, painless corneal opacity at the site of the previous pterygium apex. What is the most likely complication?

A 52-year-old male farmer from rural Maharashtra presents with a 3-year history of progressive blurring of vision in the right eye. On examination, he has a triangular, fleshy vascularized tissue originating from the nasal conjunctiva and encroaching onto the cornea, crossing the limbus. The tissue is firm on palpation. Visual acuity is 6/9 in the right eye. What is the most likely diagnosis, and which of the following is the primary risk factor for this condition?

A 48-year-old male outdoor construction worker from coastal Tamil Nadu presents with progressive nasal-sided corneal encroachment in both eyes over the past 5 years. He has undergone surgical excision of the right pterygium 2 years ago, but the lesion has recurred. Preoperatively, he was not given any adjuvant therapy. On current examination, the recurrent pterygium is approaching the visual axis. What is the most appropriate next step in management to reduce the risk of recurrence?