Pterygium
Pterygium is a non-cancerous growth of tissue that forms on the conjunctiva, which is the clear tissue that covers the white part of the eye (sclera) and lines the inside of the eyelids.
In this article you will find information about the following:
What is a Pterygium?
Pterygium is a non-cancerous growth of tissue that forms on the conjunctiva, which is the clear tissue that covers the white part of the eye (sclera) and lines the inside of the eyelids. It typically starts on the inner corner of the eye and grows towards the cornea, the clear front surface of the eye.
Pterygium is often associated with long-term exposure to ultraviolet (UV) light, such as from sunlight, as well as environmental factors like dust, wind, and dry climates. It is more common in individuals who spend significant time outdoors, especially in sunny or tropical regions.
What are the symptoms of Pterygium?
Pterygium may not cause any symptoms initially, but as it progresses, it can lead to several problems, including:
-
Redness and inflammation: The presence of a pterygium can cause redness, irritation, and inflammation of the affected eye. This can result in discomfort, a gritty sensation, and occasional eye pain.
-
Blurred or distorted vision: If the pterygium grows and extends onto the cornea, it can affect the shape and smoothness of the cornea. This can lead to astigmatism, a refractive error that causes blurred or distorted vision. In some cases, pterygium can directly cover the visual axis, causing visual obstruction and decreased vision.
-
Dryness and foreign body sensation: Pterygium can disrupt the tear film on the surface of the eye, leading to dryness and a persistent foreign body sensation. This can cause discomfort, itching, and a feeling of something being stuck in the eye.
-
Corneal changes: In advanced cases, pterygium can induce changes in the cornea, such as corneal thinning, scarring, or irregular astigmatism. These changes can further impair vision and may require specialized management.
If a pterygium is causing significant discomfort or visual disturbances, or if it is cosmetically bothersome, medical intervention may be necessary. Treatment options for pterygium include:
-
Lubricating eye drops or artificial tears to relieve dryness and discomfort.
-
Medications such as steroid eye drops to reduce inflammation.
-
Surgical removal of the pterygium, which may involve techniques to prevent its recurrence and restore a smooth corneal surface.
Prevention of pterygium involves protecting the eyes from excessive UV exposure by wearing sunglasses that block both UVA and UVB rays and using hats or other forms of eye protection when outdoors.
If you suspect you have a pterygium or are experiencing eye symptoms, it is advisable to consult with an eye care professional for a proper diagnosis and appropriate management.
What is Pterygium surgery and what are various options of pterygium removal?
Copyright: Image from “The Scrub's Bible pp 179–185”
Pterygium surgery is a procedure performed to remove a pterygium, which is a non-cancerous growth of tissue on the conjunctiva (the clear tissue covering the white part of the eye and the inside of the eyelids). Surgery may be recommended if the pterygium is causing significant discomfort, affecting vision, or causing cosmetic concerns.
There are several options available for pterygium removal, and the choice of technique depends on factors such as the size, location, and severity of the pterygium, as well as the surgeon's preference and expertise. Here are some common surgical options:
-
Excision with conjunctival autograft: This is the most common surgical technique used for pterygium removal. It involves surgically excising the pterygium and then covering the bare area with a graft of healthy conjunctival tissue taken from another part of the same eye (autograft). The graft is usually secured with sutures or tissue adhesive to promote healing and reduce the risk of pterygium recurrence.
-
Excision with amniotic membrane graft: Instead of using conjunctival tissue, an amniotic membrane graft can be used to cover the bare area after pterygium removal. The amniotic membrane, obtained from the innermost layer of the placenta, is rich in growth factors and has anti-inflammatory properties that aid in healing and reduce scarring.
-
Bare sclera technique: This technique involves removing the pterygium without placing a graft to cover the defect. While it is a simpler and quicker procedure, the bare sclera technique has a higher risk of pterygium recurrence compared to grafting techniques. It is generally reserved for cases where grafting is not feasible or appropriate.
-
Adjunctive therapies: In some cases, additional therapies may be used during or after pterygium surgery to reduce the risk of recurrence. These may include the use of antifibrotic agents (such as mitomycin C or 5-fluorouracil) or the application of fibrin glue or tissue adhesive to enhance graft adherence.
The choice of surgical technique and any adjunctive therapies will be determined by your eye care professional or ophthalmologist based on the specific characteristics of your pterygium and your individual needs.
Following pterygium surgery, it's important to carefully follow post-operative instructions, including the use of prescribed medications, attending follow-up visits, and taking precautions to protect the eye from UV light and other irritants. Proper post-operative care can help promote healing, reduce the risk of complications, and minimize the chances of pterygium recurrence.
Consultation with an experienced eye surgeon is essential to determine the most appropriate surgical approach and to discuss the potential risks, benefits, and expected outcomes of pterygium surgery in your case.
What post operative care is needed after pterygium surgery?
​
After pterygium surgery, it is important to follow post-operative care instructions provided by your eye surgeon. The specific recommendations may vary depending on the surgical technique used and individual circumstances, but here are some common post-operative care guidelines:
-
Medications: Your surgeon may prescribe eye drops or ointments to use after surgery. These medications help prevent infection, reduce inflammation, and promote healing. Follow the prescribed dosage and frequency as instructed and be sure to wash your hands before administering the drops or ointments.
-
Eye patch or shield: You may be advised to wear an eye patch or protective shield over the operated eye for a certain period, especially during sleep or activities that may expose the eye to potential injury. This helps protect the eye and promote healing.
-
Avoid rubbing or touching the eye: It is important to avoid rubbing or touching the operated eye, as this can interfere with the healing process and increase the risk of infection. If you experience itching or discomfort, consult your surgeon for appropriate recommendations.
-
Use of protective eyewear: After pterygium surgery, it is essential to protect your eyes from excessive UV light and other irritants. Wear sunglasses that block UVA and UVB rays when outdoors and consider using protective eyewear in situations where your eyes may be exposed to dust, wind, or other potential irritants.
-
Follow-up visits: Attend all scheduled follow-up visits with your eye surgeon. These appointments allow the surgeon to monitor the healing process, remove any sutures if necessary, and assess the overall success of the surgery. Be sure to discuss any concerns or changes in symptoms during these visits.
-
Avoid strenuous activities: For a period of time following surgery, you may be advised to avoid strenuous activities that can strain the eyes or increase the risk of injury. This may include activities such as heavy lifting, bending, or participating in contact sports. Follow your surgeon's guidance regarding when it is safe to resume these activities.
-
Maintain good hygiene: Practice good hygiene by washing your hands frequently, especially before applying eye drops or touching the operated eye area. Avoid exposing the eye to water or irritants that could potentially cause infection or complications for at least 2 weeks or till the tissues heals properly.
It is important to note that these are general guidelines, and your surgeon may provide specific instructions tailored to your situation. If you have any questions or concerns about the post-operative care after pterygium surgery, do not hesitate to reach out to your eye surgeon for clarification and guidance.
Don't take our word for it!
Reviews from happy patients
C
Mr Rana’s care of me has been excellent. He has explained things very clearly and performed the surgery expertly and quickly. I have complete faith in him and look forward to him continuing to be available to monitor my needs.
S.Q
I would without hesitation recommend Mr Rana. His knowledge & experience of complex corneal conditions is unparalleled. He always seeks to explain options, risks, expected outcomes & timescales. I trust him implicitly to provide the best possible care and outcome for my condition
W.H
Mr. Rana is a Consultant Surgeon with whom I have had the greatest confidence in since our initial interaction a few years ago. He has instilled a lot of confidence in me moving forward with my eye care & I am extremely grateful. I have & would definitely recommend Mr Mrinal Rana
