Pterygium

What is a Pterygium?

A pterygium (pronounced “teh-ridge-eeum) is a wedge-shaped growth of conjunctival tissue on the surface of the eye. It typically grows from the inner corner of the eye, onto the cornea at the centre of the eye. In rarer cases, it can grow from the outer corner of the eye. A pterygium is not a cancer and does not become cancer. The growth of a pterygium is unpredictable, and varies from person to person.

What causes a Pterygium?

Pterygia (plural of pterygium) usually present in patients over 20 to 30 years of age. The exact cause of a pterygium is unknown, however Ultraviolet (UV) light exposure is known to be a major risk factor, along with long term exposure in windy or dusty environments, dry eyes, and genetic factors.

Treatment for Pterygium

Many pterygia will remain stable and not require intervention. However, in some cases treatment may be required.

Artificial Tears

Given the fleshy, raised nature of the tissue growth, pterygia can become red and inflamed in dry, windy or dusty conditions. Using artificial lubricants can provide moisture and hydration to the eye surface, and reduce inflammation and irritation.

Eye Protection

Wearing sunglasses or protective eyewear when outdoors is recommended to reduce UV exposure, dust and wind.

Surgical Removal

Indications for Surgery include:

  • Cosmesis – pterygia can give the eyes an unsightly, red and inflamed appearance. Some patients find this disconcerting and would like to remove the pterygium due to cosmetic concerns.
  • Ocular surface – the raised nature of a pterygium can cause many patients to feel a constant foreign body sensation, which causes the eye to feel gritty and uncomfortable. They are also more prone to dry eye complications as the natural tear secretions are not evenly distributed across the eye surface when a pterygium is present.
  • Vision – if the pterygium extends across the cornea, vision can be obstructed. Blur, shadowing and distortions are common vision complaints.

Pterygium Surgery

Pterygium removal surgery is performed under local anaesthetic, and the eye is completely numb during the procedure. A small cut is made around the pterygium, which is then lifted upwards and cleared from the cornea. The pterygium is removed and a free conjunctival graft is performed. This involves taking a small portion of the conjunctiva from under the upper eyelid and attaching it to the site of the excised pterygium.

In the past, pterygium removal was performed without placement of a free conjunctival graft and high rates of regrowth occurred. As the surgery is now performed with a free conjunctival graft, the regrowth rate is very close to zero.

Recovery

Following surgery, antibiotics and anti-inflammatory medications are used on the eye. A patch is offered for 24 hours after the surgery for comfort and protection. The eye will look bruised and may be irritable for several weeks. There are stitches on the graft which dissolve over six weeks and the eye becomes white and settles after that time.

Protection from ultraviolet light wind and dust is suggested during this period. Post-operative visits are required during this time.

As with any surgery there are risks and an informed consent form will be given prior to the surgery.