Pterygium

A Pterygium is a benign or non cancerous growth that develops on the conjunctiva of the eye. The conjunctiva is a clear, thin tissue that covers the white part of the eye, known as the sclera.

Pterygiums may develop in one or both eyes. The lesion is characterized by a pinkish, triangular-shaped tissue growth of conjunctiva that extends towards the cornea (a transparent window covering the front of the eye). It usually occurs on the nasal side of the eye. The color of the lesion varies from pink to red in color. It may be small or may grow large enough to interfere with vision. A pterygium is also called Surfer's Eye.

Causes.

The cause of pterygium eye disease is not known, but it can occur more often in people who spend time outdoors with frequent or excessive exposure to sunlight or wind. People who spend considerable time in the sun such as farmers, fishermen, and people living near the equator are more likely to develop pterygium. Genetic predisposition is another factor that may play a role.

Symptoms.

The primary symptom of a pterygium is a painless area of elevated tissue with visible blood vessels on the inner or outer border of the cornea. The condition can cause extreme eye discomfort including burning, irritation, redness, tearing, foreign body sensation, and astigmatism (visual defect). If the growth becomes large enough, it may begin to inhibit vision.

Diagnosis.

To diagnose pterygium, your ophthalmologist or eye doctor conducts a complete physical examination of the eye and eyelids. No special tests are necessary.

Treatment.

Treatment depends on the size and extent of the pterygium. Treatment is usually not required in mild cases.

When a pterygium becomes red and irritated, steroid eye-drops may be prescribed to reduce the inflammation. If these drops are recommended, you should remain under the care of your ophthalmologist.

In cases in which the growth is unsightly or vision is threatened, your ophthalmologist may recommend surgical removal of the tissue.

The patient will be provided preoperative counseling to inform them that although surgery is usually successful, sometimes the symptoms are not completely relieved, the recurrence rate is frequent and it tends to spread quickly after recurring.

The most common surgical technique used today involves a simple excision of the pterygium combined with conjunctival auto-grafting. During the procedure, the pterygium is removed and the gap in the conjunctiva left by the removal of the pterygium is filled with a tissue transplant from the upper eyelid. The graft is held in place either with sutures, fibrin sealant or glue. This graft covers the excised area and acts as a barrier to recurrence.

In some cases, following simple excision, a topical therapy and beta-radiation may be used to minimize the recurrence of pterygium. Although these therapies may slow the re-growth of the pterygium, complications such as ulceration and perforation in the wall of the eye may occur so are not always recommended.

In severe cases where the growth extends towards the center of cornea, a laser treatment may be needed. An Excimer laser is used to smooth the surface irregularities and improve vision.

Post-operative Care.

Following surgery, you may experience soreness and irritation in your eye for a few days for which antibiotic/steroid combination eye drops may be recommended. You may also have redness of the eye which usually resolves on its own. You can return to your normal activities within 1 or 2 weeks after surgery. Make sure to use the eye-drops and take protective measures as directed by your doctor.

Risks and Complications.

As with any procedure, risks and complication may occur. The pterygium may recur during the first 12 months following surgery. Other surgical complications include scarring and perforation of the cornea (clear, outer covering of the eye ball) and astigmatism (blurred vision). Prevention.

Preventive measures include protecting the eyes from ultraviolet rays by wearing sunglasses with UV protection during outdoor activities, and applying artificial tear drops to lubricate the eyes.

A pterygium is often a painless, benign lesion in the eye that does not cause any problems or require any treatment. However, in some cases it can become inflamed causing extreme eye discomfort and spread over the cornea, affecting vision. Conservative treatment with eye drops is used initially with surgery recommended only when symptoms are unresolved with medical therapy and vision is affected.