EYE DISEASES  
PTERYGIUM
 

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This growth of pink, fleshy tissue on the white of the eye is commonly found in people who spend a lot of time outdoors.

It usually forms on the side closest to the nose. It is a noncancerous lesion that usually grows slowly throughout life. It can continue growing until it covers the pupil of the eye and interferes with vision.

Or it may stop growing after a certain point. A pterygium that affects both eyes, is called a bilateral pterygium.

 

Symptoms

Most of the time, a pterygium causes no symptoms other than its appearance. However, a very large one may cause redness and inflammation.
The pterygium can also grow onto the cornea and distort its shape, causing astigmatism and blurred vision.
Symptoms of pterygium may include:

  • Burning
  • Gritty feeling
  • Itching
  • Sensation of a foreign body in the eye
  • Blurred vision

Causes

The cause of Pterygium is unknown (idiopathic). But most experts believe that significant risk factors include:

  • Prolonged exposure to ultraviolet light
  • Dry eye
  • Irritants such as dust and wind

Occurrence is greater among people living near the equator, or in a sunny climate. Most often seen in young adults’ aged 20 to 40.


Treatment

See an ophthalmologist if you have symptoms of pterygium. He or she can diagnose the condition by examining the front part of your eye with a microscope called a slit lamp.

Pterygium usually does not require treatment if symptoms are mild. If a temporary worsening of the inflamed condition causes redness or irritation, it can be treated with:

  • Lubricating eyedrops or ointments
  • Occasional use of vasoconstrictor eyedrops
  • Short course of steroid eyedrops

If the lesion causes persistent discomfort or interferes with vision, it can be surgically removed during an outpatient procedure. You and your doctor may also take into account appearance and the size of the pterygium when making a decision about surgery.
Surgery has a risk of complications, such as the recurrence of a more aggressive lesion. So surgery is usually considered only if:

  • Conservative treatments have failed
  • The patient's eyesight is at risk

The type of surgery most commonly used today uses the patient's own conjunctiva (surface eye tissue) or preserved amniotic membrane (placenta) to fill the empty space created by the removal of the pterygium. In this procedure, the pterygium is removed and the conjunctiva or amniotic membrane is glued or stitched onto the affected area.


Pterygium surgery typically takes 30 to 45 minutes. After surgery, patients usually need to wear an eye patch for a day. But they can return to work or normal activities (avoiding swimming and eye rubbing) after a few days.


Often, patients are told to use steroid eyedrops for several weeks. This will reduce inflammation and prevent pterygium recurrence.
The main complication of pterygium surgery is recurrence after removal. Without a conjunctival or amniotic graft, the recurrence rate is nearly 50%. Pterygium removal with a conjunctival or amniotic graft is associated with a much decreased recurrence risk of 5%-10%.
Surgical complications may also include corneal scarring and perforation. In some cases, surgical removal of pterygium can cause astigmatism.


Patients need to be carefully followed for a year because 97% of recurrences occur during the first 12 months after surgery.


Prevention

  • Wear sunglasses. Wraparound ones provide the best protection against ultraviolet light, dust, and wind.
  • Make sure they block 99%-100% of both ultraviolet A (UVA) and ultraviolet B (UVB) type radiation.
  • Wear a hat with a brim to protect the eyes from ultraviolet light.
  • Keep eyes moist in dry conditions with artificial tears.