Chronic UV exposure is a major risk factor, but how this might result in pterygium formation has not been elucidated. Pterygia typically form on the nasal aspect of the cornea. Reasons for this are unknown. It has been postulated that the temporal limbus may be shaded to a greater extent than the nasal limbus, by the eyelashes, eyelid curvature, and brow, or that total internal reflection within the cornea may focus light preferentially at the nasal limbus. [11] It has been suggested that dysfunction of the corneal epithelial limbal stem cells caused by chronic UV exposure may be important, disrupting the normal barrier that prevents the conjunctiva from growing onto the cornea. [12] Others have postulated that pterygium formation is primarily the result of a degenerative alteration of the conjunctiva rather than the limbal stem cells. Other factors suggested to be involved in the pathogenesis of pterygia include hereditary or immunologic mechanisms, chronic ocular irritants, tear film anomalies, and the human papilloma and Epstein-Barr viruses.