Pterygium Surgery

What is a Pterygium?

Pterygium is a growth from a thin tissue that covers the wall of the eye called the conjunctiva. When a pterygium develops, the cells from the conjunctiva develop into a mobile blood vessel filled tissue, very much like a moving scar. Over months or even years, the cells crawl on the clear part of the eye called the cornea. The cornea is a clear cover that directly lies in front of the colored part of the eye called the iris. Some people have brown, hazel or blue irises. The pterygium crawls on the clear cornea and creates a wing-shaped red growth on the corner of the cornea, usually on the side closest to the nose (though it can be both sides). Pterygiums are not a cancerous growth, so it does not pose any risk to your health. Pterygium however, if left unchecked can obstruct your vision if it covers the pupil. It can also create corneal irregularity, generating a large amount of astigmatism. Most commonly, pterygiums cause irritation and redness is the eye and can cause a foreign body sensation.

When should a Pterygium be removed?

Most pterygiums do not cause a problem and can simply be observed. Pterygiums should be removed if they start causing the following symptoms:

  • Reduced vision from pupil obstruction.
  • Irregular cornea or the development large astigmatism.
  • Constant eye irritation that does not respond to steroid drops.

What can happen if a Pterygium is ignored?

It is rare to see advanced pterygiums in the U.S. because of greater access to eye surgeons. In underdeveloped parts of the world, or in part of the U.S. where access to eye surgery is more limited pterygium can cause permanent scarring on the cornea and cause an irregular cornea. Even in these situations the reduction in vision is usually mild and can be treated with a hard contact lens. Having said that, not ignoring a growing pterygium is the best approach.

What is Pterygium Surgery?

Pterygium surgery is a simple procedure where the eye surgeon removes the growth on the cornea, and on the white part of the eye called the sclera. There are several different techniques to remove the pterygium. Some surgeons will remove the growth and close the tissue with sutures. Others will use a glue, and others will use a graft to help the surface heal better. There are several grafts available, including amniotic membrane graft or harvested grafts from the healthy part of the eye. The biggest challenge with pterygium removal is that it can recur more aggressively than before. Therefore, the removal technique used, and the completeness of the removal, are important. A more aggressive removal may have side effects, so the surgeon balances the pros of complete removal versus the possible side effects.

What causes Pterygiums?

Ultraviolet light, wind, and chronic irritation cause pterygiums. They are more common at the equator, in individuals who work under the sun, such as farmers, roofers and construction workers. It is also more common in recreational sports such as surfing. Wearing sunglasses reduces the chances of developing pterygiums.