Pterygium


Pterygium is a white or pinkish fleshy growth that develops across the clear window of the eye called the cornea. This usually affects people who spend a lot of time outside in the sun or who have lived in hot and dusty climates. It usually forms on the nasal side of the cornea. It can cause discomfort and if the growth is not dealt with it can occasionally interfere with vision.


What are the symptoms of pterygium?

A pterygium does not always cause any symptoms but if growing may cause redness and inflammation. It also can distort the shape of the cornea causing an astigmatism which can result in blurred vision. Sometimes the pterygium can grow onto the cornea and cover the pupil, which will interfere with vision. Symptoms may include burning, grittiness, itching, foreign body sensation and blurred vision.



What causes pterygium?

A pterygium usually occurs in those aged 20 - 40 and is more common in men than women. Some risk factors include prolonged exposure to sunlight, dry eyes and irritants such as dust and pollution.



How is pterygium treated?

The majority of pterygia in the United Kingdom are very slow growing, cause only mild symptoms and do not require surgical removal unless for cosmetic reasons. If a temporary worsening of the inflamed condition causes redness or irritation, it can be treated with lubricating eyedrops ('artificial tears') or ointments or a short course of steroid eyedrops. If the lesion causes persistent discomfort or interferes with vision, it can be surgically removed as a day case procedure. The surgery is usually performed under local anaesthesia (awake) but can be done under general anaesthesia (asleep), if required. The choice is based the patient's own preferences. As with any surgery, there is a risk of complications, the most common of which is recurrence. The type of surgery most commonly performed today in the surgical treatment of pterygium uses a graft from the patient's own conjunctiva (the thin tissue covering the white of the eye) to fill the empty space created by the removal of the pterygium and to act as a barrier against its future regrowth. In this procedure, the pterygium is removed and the conjunctival autograft is sutured between the cornea and the affected area of remaining conjunctiva. Pterygium surgery typically takes about 45 minutes and patients are usually able to go home on the day of the operation. There is a return for a check-up the day following surgery. If you are using any eye treatment before the operation, check whether it needs to be continued after the operation. After surgery, an antibiotic / steroid eye drops mix such as Maxitrol is used four times a day for a week and then reduced slowly over the next three weeks. An eye lubricant is also used four times daily, in between using the antibiotic/steroid mix.



Precautions following treatment

The eye surface is vulnerable to infection until it is fully healed, so it is important to keep the eye clean and avoid contamination. Wash your hands before touching your eye, and do not touch the tips of dropper bottles or ointment tubes. Do not go swimming until you have been told it is safe to do so. It is also important to take extra care to avoid accidental injuries. Avoid rubbing your eyes, do not engage in contact sports for two weeks, and wear eye protection for any hazardous activities such as using hammers or grinding tools or operating machinery.



Are there any complications of surgery?

The main complication of pterygium surgery is recurrence after removal. The chance of a recurrence after a first operation is between 3-20%. Other surgical complications are rare, but may include corneal scarring and perforation (this is very rare). In some cases, surgical removal of a pterygium can cause astigmatism. Patients need to be followed up for a year because most recurrences occur during the first 12 months after surgery.



Can pterygium be prevented?

Wearing sunglasses every day, even on cloudy days may help prevent pterygium formation . Please choose sunglasses that block 99%-100% of both ultraviolet A (UVA) and ultraviolet B (UVB) radiation. Wraparound sunglasses provide the best protection against ultraviolet light, dust and wind. Wearing a hat with a brim can also help protect the eyes from ultraviolet light. To keep your eyes moist in dry conditions, apply artificial tears. This also helps reduce the chances of pterygium recurrence.