Pterygium

Pterygium is a wedge shaped growth of thickened tissue that crosses the white part and coloured part of the eye.  Usually it occurs on the nasal/inner side of the eye but can occur on the outer side as well.

It is benign.

The cause in unknown but UV radiation from the sun is thought to be a major risk factor.

A pterygium causes irritation, discomfort and watering.  It can become red and look cosmetically unattractive.  It can change the shape of the eye, causing astigmatism and blurring of vision.  If it grows too close to the pupil it can threaten vision.  It can also make wearing contact lenses difficult or not possible.

Treatment options include:-

Conservative management with sun protection (hat and sunglasses) and artificial tears.

Or

Surgery to remove it.

Surgery is usually done under local anaesthetic or regional block to numb the eye.

Simple excision is not recommended as the recurrence rate is unacceptably high (up to 50% or more).

Excision with adjunctive therapies such as mitomycin C or 5 fluorouracil or a small dose of beta irradiation can be used.  However these treatments have significant risks or sight threatening complications.

Excision with conjunctival autograft is generally recognised as the standard of care.  The graft is taken from conjunctiva under the upper lid and either sutured or glued into place.  The recurrence rate with this method is around 5% - 10%.

The decision to have surgery is usually for the following reasons:-

1. Irritation, discomfort and tearing

2. Cosmesis

3. Significant astigmatism causing blurring of vision

4. Threat to sight if the pterygium grows too close to the pupil.

Post-surgery the eye will be uncomfortable for a few days and pain-killers may be required.  You may have a foreign body sensation.

Drops may be needed after surgery for up to 2 months.