Pterygium: Causes, symptoms and treatment

What is pterygium?

Pterygium is sometimes referred to as surfer’s eye and is pronounced tur-rij-ium. A Ptergium is a benign (non-cancerous) growth and is a pink, fleshy tissue which has blood vessels and grows on the conjunctiva (the clear, thin membrane that covers part of the front surface of the eye and the inner surface of the eyelids). It is often shaped like a wedge and usually appears on the side of the eye, usually near the nose. In more extreme cases, it can cover the pupil and cause vision problems. If you have more than one growth, the plural term for pterygium is pterygia (tur-rij-ee-ah). If it affects both eyes, it is known as bilateral pterygium.

A pterygium may start as a pinguecula - a protein, fat or calcium deposit appearing as a yellowish, raised growth on the conjunctiva.

What causes pterygium of the eye?

Pterygium is most commonly caused by UV radiation. It is often associated with surfers who spend long hours out in the sun and have to contend with direct UV rays from the sun and reflective UV rays from seawater. However, it is notisolated to just surfers and can affect anyone who spends extended amount of time outdoors (without wearing proper sunglasses) in the sun or exposed to certain elements, regardless of whether they are an athlete or not. Other factors linked to pterygium causes are:

• Dust and wind
• Sand
• Smoke
• Pollen

Pterygium is more likely to affect those between the ages of 20-50 years old (especially men) and people who live in areas with high levels of ultraviolet UV light. If you have light skin and eyes, you are also at a higher risk of developing a pterygium.

What are the symptoms of pterygium?

In many cases, people find they have no symptoms; the growth shows up unexpectedly. Others may experience a yellow spot or bump on the white part of the eye (sclera) or the feeling of something being in their eye. Itchiness, red eyes, blurry vision, dry eyes and a gritty or burning sensation are also common.

Nevertheless, the growth on your eye can affect vision if it gets big enough to cover your cornea. It can distort the shape of the eye’s front surface causing astigmatism. You may feel as though you have a foreign object in your eye if the pterygium is large or thick.

Preventing pterygium

The best way of preventing pterygium is to wear sunglasses with 100% UVA and UVB protection. This also applies to people who have a pterygium to slow down the growth as well as those who have had it removed and don’t want it to come back. We would recommend opting for wrap around frames as these offer the most coverage and protection from the sun. Wearing a wide brimmed hat as an extra form of protection is also highly recommended.

How do you treat pterygium?

Surgery is sometimes required as a treatment to remove a pterygium, especially if it is causing sight problems. However, this depends on the size and whether it’s growing.

Surgery for this procedure is rare in the UK as most cases can be managed by using eye drops to reduce inflammation and keep the eye lubricated. Regular sight tests are important to monitor growth and/or any other changes.

You may be prescribed mild steroids or lubricants by your eye care professional/ optician. These reduce swelling, redness, dry eyes and other irritating symptoms. Other treatments include topical cyclosporine and sometimes contact lenses are used to cover the growth and to protect the eye from further UV exposure.

Pterygium eye surgery

If surgery is required (for both visual and cosmetic reasons), there are several surgical techniques available. Your ophthalmologist will determine which treatment suits you best before operating, which usually takes no more than 30 minutes.

In some cases, pterygium removal can cause astigmatism or worsen the condition for those who already have it. Your eye will need to be monitored after surgery for the recurrence of growth and you’ll need to use eye drops for several weeks after the removal. You'll also need to wear an eye patch to protect the eye for a few days, though you should be able to return to doing regular activities the next day.

It isn't uncommon for pterygia to return after surgery should the eye be continuously exposed to high levels of UV rays.

There are some preventative measures you can take to reduce the chances of reoccurrence. Wearing sunglasses with built-in 100% UVA and UVB protection will limit your exposure to ultraviolet and offer sufficient eye protection. You can also opt for photochromic sunglasses or Transitions; these feature lenses which change tint depending on the surroundings. For example, they will darken in bright and sunny conditions and lighten when indoors or when it is cloudy outdoors.

Our entire range of sunglasses has 100% UVA and UVB protection, while we also stock sports sunglasses from Dunlop and Oakley for athletes and active individuals.

Mitomycin C, an agent that prevents scarring by inhibiting the reproduction of cells that produce scar tissue, may be applied at the time of or after the surgery.

Another option of pterygium surgery is a conjunctival autograft. It involves removing the limbal tissue and adjacent conjunctiva from one part of the patient's eye and using it to cover the spot where the pterygium was. This procedure is more likely to prevent the pterygium from growing back.

Can pterygium go away on its own?

While a pterygium may look and seem alarming, it is possible for it to go away without any treatment whatsoever. However, an eye care specialist is best to decide the severity of the pterygium and determine whether surgical removal of the pterygium is necessary.

Pterygium Diagnosis

Your optician will be able to diagnose a pterygium by taking a close look at your eyes with a magnifying slit lamp. They will be able to distinguish the growth from other eye conditions such as dry eye, red eye and pinguecula.

In addition to a slit lamp test, they will also use an eye chart to test your visual acuity as well as take photos to monitor the growth of the pterygium. They will also see you on a regular basis for eye exams.

What are the best eye drops for pterygium?

Artificial tears and over the counter eye drops, for example, Systane Lubricant Gel Drops, Blink eye drops can relieve irritation and redness caused by pterygium. However, it is best to speak with your optometrist regarding which eye drops or ointments are suitable for you. An ophthalmologist can prescribe specialist eye drops.

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