Pterygium Treatment

What is a pterygium?

A pterygium (pronounced “te-ridge-e-um”) is a raised, triangular or wedge-shaped, benign growth of conjunctiva tissue that may occur in one eye or both. The conjunctiva is the mucus membrane that covers the front of your eye. It usually begins on the side of your eye nearest your nose. A pterygium can grow over the cornea (the window at the front of the eyeball). As it develops it may alter the shape of the cornea making it curve more. This causes astigmatism which affects how your eye focuses. When the pterygium has grown towards the centre of your cornea it will affect your vision.

Pterygium comes form he Greek word meaning wing, pterygos.

What causes a pterygium to grow?

People who have had chronic sun exposure (ultraviolet light) due to excessive outdoor activity such as farmers, or surfers and other water-sport athletes, and snow-sport athletes are the common groups of people who develop a pterygium. Exposure to wind or dust are also risk factors.

It is usually seen in the older age (commonly around 40-50 years) and predominantly the male sex. Countries closer to the equator have higher rates of occurrence, as does New Zealand due to the a reduced ozone layer.

What are the signs and symptoms of a pterygium?

The symptoms include persistent redness and inflammation of the eye, a feeling that something is in the eye (foreign body sensation), tearing, dry and itchy eyes. Many people are also bothered by the cosmetic appearance of the growth on their eye.

What treatments can help with pterygia?

Treating pterygia varies depending on the size, nature and symptoms of the pterygium. The two main treatments are the use of eye drops and surgery.

Artificial teardrops are available without a prescription from the pharmacy, which will lubricate the surface of the eye to improve comfort and decrease any redness. They are safe to use on a regular basis.

If a pterygium becomes particularly inflamed non-steroidal or steroid anti-inflammatory drops may be prescribed for a short period by your ophthalmologist.

Decongestant drops, such as ‘Clear Eyes’ are not recommended as they can cause rebound redness, making your eye worse.

Protecting your eyes from ongoing ultraviolet light exposure may reduce the chance of a pterygium growing bigger, so sunglasses and a large brimmed hat are recommended to be worn when outside.

When symptoms persist despite medical treatment, surgical removal of the pterygium may be required.

What does the surgery involve?

You may be advised to have an operation to remove the pterygium if it is causing constant eye irritation, problems with your vision, or you are unhappy with how it affects your appearance, or if it is interfering with your contact lens wear.

The current surgical management is with conjunctival autograft surgery. This technique has been shown to safely and effectively reduce the risk of the pterygium growing back.

The surgery takes around 15-20 minutes and can be done under local anaesthetic (so you don’t feel anything) as an outpatient procedure at the Bowen Eye Clinic purpose built surgery facility.

Surgery involves the pterygium being carefully removed and a graft (a small piece of healthy conjunctival tissue, from under the upper eyelid) being put over the same area where the pterygium was removed on the white of your eye. The graft helps the site to heal and with the modern technique it is glued on using a fibrin glue.

Eye drops are prescribed after surgery to prevent infection and assist with healing.

You will need to have someone to drive you home after the surgery.

What do I need to do when I go home?

You eye is left open so that you can apply your eye drops. An eye shield is provided to use at night so that you do not accidentally rub your eye while you sleep. Your doctor will make a follow up appointment for the day after your surgery to check the healing of your eye. Take care not to poke or rub your eye. You can bathe or shower as normal.

Your eye may be sore for about three to seven days after the operation. You will be prescribed pain medication, antibiotic eye drops (to reduce any risk of infection) and steroid eye drops (to reduce inflammation) to use after the surgery. The steroid eyedrops are used for 3 months to prevent a recurrence of the pterygium. The graft will be red and swollen initially. It can also turn a yellow colour at one week, this is normal. Your eye can be red reducing to pink for about six to twelve weeks and then it will settle. If you normally wear contact lenses, your ophthalmologist will advise you when you can start to wear them again. You should avoid swimming for at least two weeks to reduce any risk of infection. You may need time off work and off driving, so please ask the doctor for a medical certificate if you require one.

If the pain or redness worsens, despite regular medication, please phone the clinic to talk to your surgeon.

Will the pterygium grow back?

A pterygium may recur in around 1-2% of the cases that have surgery to remove it.

To reduce the risk of a pterygium recurring we recommend:

- complete your course of steroid eyedrops

- using sunglasses that block out ultra-violet light (close fitting, wrap around styles are best)

- wear sunglasses and a hat with a wide brim when outdoors

- avoid exposure to environmental irritants e.g smoke, dust, wind and chemical pollutants

- use appropriate eye safety equipment in work environments.

 

If you would like to have an assessment of your pterygium and discuss your treatment options

please contact Bowen Eye Clinic on 0800 69 2020 for an appointment.