Objective: To assess the role of Anti VEGF agent in management of primary pterygium. 

Study Design: Prospective Study. 

Methodology: This prospective comparative study included twenty (20) eyes with primary nasal pterygium and off label use of a single dose of subconjunctival injection of Bevacizumab (0.05 ml, 

1.25 mg) injected in the body of pterygium. The vascularity, thickness and size (in cm2) was recorded at baseline and 08 weeks after injection. The main outcome measures were the change in size, vascularity and thickness. 

Result: There were 16 males (80%) and 04 females (20%), with a mean age of 41.5 yrs. There was no significant difference in the mean surface area of pterygium at different time intervals. However, the thickness and vascularity of the pterygium was significantly reduced. There was a significant difference in the pterygium grading by 2 masked observers at different times. At baseline, there were 14 (70%) grade II and 6 (30%) grade III pterygium. At 08 weeks post injection, there were 7 (35%) with grade I pterygium, 10 (50%) with grade II & 3 (15%) with grade III pterygium. No serious ocular or systemic side defects were observed. 

Conclusion: Single dose subconjunctival injection of bevacizumab resulted in regression of pterygium thickness and vascularity. However, local injection of bevacizumab showed no significant difference in the size of the pterygium at the end of 08 weeks. The long term effect of anti VEGF agent in the management of primary pterygium requires further evaluation.