Pterygium Treatment

Causes and treatment of Pterygium and other ocular surface lesions

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What is a Pterygium?

A pterygium (pronounced ter-i-jee-um) is when the conjunctiva (the thin, translucent layer of skin that normally covers the white of the eye and the back of the eyelids) begins to grow across the cornea (the round clear window at the front of the eye, just in front of the coloured iris).  Most commonly, these occur as a triangular growth at the inner corner of the eye (near the nose), but they can occur on the outer side, and rarely in other positions.

Why do they occur?

The most common factor is UV/sunlight exposure.  They are most common in surfers and outdoor workers. Regular exposure to dry and dusty environments may also be a factor.

Is a pterygium dangerous?

Usually not – a pterygium is a benign growth (ie not cancer), although rarely a pterygium may have some areas of dysplasia (some of the cells are abnormal and have a small potential to develop into a cancer-like growth).

How is pterygium diagnosed?

Usually a pterygium is fairly obvious to the naked eye, but accurate diagnosis and measurement is usually done by an eye specialist by examining your eye at a slit lamp.

What problems/symptoms can a pterygium cause?

Small pterygia can cause irritation, particularly if they become dry and inflamed.  Some patients also dislike the cosmetic effect of having this growth on the inner side of their eye, as it can become quite red at times.

Larger pterygia can start to affect vision, either by direct interference with the passage of light through the cornea, or by distorting the shape of the cornea (causing astigmatism), which affects the ability of the cornea to act as a lens to help to focus light to the back of the eye.

How is a pterygium treated?

Smaller pterygia can often be managed without surgery.

  • Lubricant drops (artificial tears) from the chemist can help keep the eye comfortable and minimise redness.
  • Wearing sunglasses when outdoors minimises UV exposure, reducing irritation and the risk of the pterygium growing further
  • Occasionally, a short course of steroid eye drops may be prescribed if a pterygium becomes particularly inflamed.

However, for larger or more annoying pterygia, surgery is the most common treatment.  The main indications for surgery are:

  • If the vision is being affected, or may start to be affected if the pterygium grows any further
  • If the pterygium is causing frequent/significant irritation
  • Occasionally, a pterygium may be removed for cosmetic reasons.

Pterygium surgery is usually done under local anaesthesia, and involves removing the visible pterygium as well as some of the tissue behind it, followed by placement of a large conjunctival graft (taken from elsewhere on the same eye).  A technique involving meticulous clearance of the pterygium and careful placement of a large graft (as offered at Maroochy Eye Specialists) can minimise some of the issues traditionally associated with pterygium surgery, such as the risk of recurrence and an ongoing red eye.

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