The study compared the clinical manifestations and prognosis of 90 patients with pterygium, divided into groups A, B and C according to the pterygium score. Parameters evaluated included sex, age, time of onset, symptoms, AS-OCT, PLR, MLR and systemic immuno-inflammatory index (SII). In patients with pterygium, the values of SII, NLR and MLR were significantly higher than in the control group. The incidence of both eyes was significantly higher in group C than in groups A and B. The SII value was significantly correlated with the area of pterygium progression and the volume of weighed postoperative tissue. The combination of anterior segment phase and AS-OCT effectively assesses pterygium volume. SII serves as a biomarker to predict the severity and prognosis of pterygium, with imaging methods better assessing progression than traditional methods.[1]