Pterygium

What is a pterygium?

A pterygium (pronounced terr-ij-ee-um) is a benign overgrowth of fleshy tissue onto the front surface of the eye. The name comes from the Greek word for wing, “pteron”, as a pterygium is often shaped like a wing.

Symptoms include:

Gritty, foreign-body sensation
Watery eye
Reduced vision (due to the pterygium causing astigmatism)
A pinky-red, fleshy lump visible on the surface of the eye

Pterygium is also known as “Surfer’s Eye”, as the main risk factors are:

UV light exposure
Chronically dry or inflamed eyes (often seen in people with frequent salt-water exposure)

Having completed my second corneal Fellowship in Perth, Western Australia, I have substantial experience treating pterygium.

Pterygium treatment

In the early stages, you can sometimes prevent a pterygium getting worse by keeping your eye well lubricated with artificial tear drops and avoiding UV exposure with good quality sunglasses. This is not always successful though, and early removal with surgery offers you the best chance of a good long-term outcome as it prevents the pterygium getting to the point where it causes distortion of the vision and permanent scarring.

Surgery is a safe and effective treatment for pterygium. Surgery aims to remove the lump, improve the appearance and reduce the risk of further progression and loss of vision.

Pterygium surgery is available on the NHS but usually only after vision is affected. Many patients with pterygium prefer to have surgery earlier than this in order to remove the lump while it is still small and prevent further problems.

What does pterygium surgery involve?

After the eye is numbed, the pterygium is gently removed from the surface of the eye and the area underneath is polished to make it as smooth as possible.
Then, a small patch of conjunctival tissue is taken from under the upper eyelid to form a graft. This graft is then glued to form a patch over the area where the pterygium used to be. This helps to improve healing and prevent the pterygium growing back. Occasionally, fine sutures are required but this is uncommon. The area under the eyelid heals and quickly returns to normal.
Finally, a contact lens is placed on the surface of the eye to keep it comfortable during the early healing phase. This is then removed at your first follow-up appointment.
Surgery takes about 30 minutes and is usually performed under local anaesthetic with light sedation. You can go home immediately afterwards.
Occasionally, cautery to stop bleeding and sutures to stabilise the graft are required. However, I aim to avoid these where possible by using more gentle techniques, in order to:
- Provide maximum comfort after surgery
- Reduce inflammation (which can increase the risk of recurrence)

What are the risks of pterygium surgery?

The risk of serious complications affecting your vision is very low as pterygium surgery is all on the surface of the eye rather than inside. The main things to expect after surgery are:

Discomfort for a few days (pain is rare with modern suture-less, minimal cautery techniques)
Red eye for a few weeks
Blurry vision for 7-10 days
Depending on your occupation, you may need to take a week or two off work.
You need to avoid rubbing the eye or getting any debris, dirt or water in the eye for at least two weeks after surgery.
Anti-inflammatory eyedrops are required for at least 2-3 months.
Lubricating eyedrops (artificial tears) are recommended long-term to reduce the risk of the pterygium growing back

Rare problems that can occur after surgery include:

Infection
Graft detachment requiring further surgery
Recurrence (uncommon with modern techniques)

What should I do now?

If you’d like to find out more about pterygium surgery, please email info@southcoastvision.co.uk