Blog Post

A pterygium (pronounced tur-IJ-ee-um) is a fleshy, wedge-shaped growth that spreads from the white of the eye onto the clear cornea. It is common in Australia, where ultraviolet exposure is high, and is often called “surfer’s eye”.

Symptoms

• A visible pink or red lump on the inner or outer edge of the eye
• Irritation, grittiness, redness or a dry-eye feeling
• Blurred vision if it grows over the cornea or distorts its shape (astigmatism)

Many small pterygia cause few symptoms and can be watched. See your optometrist or doctor if one is growing, red, or affecting your sight.

When is surgery suggested?

Surgery is usually considered when a pterygium is growing toward the centre of the cornea, affecting vision, causing ongoing irritation despite lubricating drops, or when appearance is a significant concern. Surgery can also be needed before cataract surgery if the pterygium would interfere with measurements.

How surgery has changed

Older techniques simply removed the growth and left the area uncovered. Regrowth was common. Modern surgery removes the pterygium and then covers the area with a thin piece of healthy conjunctiva taken from under the upper eyelid, called a conjunctival autograft. This graft substantially lowers the chance of regrowth.

The graft can be held in place with stitches or with a biological tissue glue (fibrin glue). Reviews of the research, including a Cochrane review, found that glue reduces operating time and may reduce recurrence compared with stitches. Many patients also report less irritation in the early days because there are no suture ends to rub against the eyelid. Glue is made from human blood plasma components, and a very small theoretical risk of transmitting infection applies, as with other blood-derived products. Dr Abell uses a combination of sutures and surgical glue, often depending on patient preference, since the glue usually results in an out-of-pocket cost to patients.

What to expect

• The operation is usually done as a day procedure with local anaesthetic and sedation.
• The eye is usually padded for a short time, then you use prescribed drops for several weeks.
• Redness settles over weeks to a few months.
• You will need follow-up visits to check for regrowth.

Risks

As with any surgery, there are risks, including recurrence, infection, bleeding, graft problems, double vision and, rarely, scarring that affects sight. Using sunglasses and a hat outdoors helps reduce the chance of regrowth, and lubricating drops can help with comfort.

Who should see a specialist?

You should consider referral if the growth is enlarging, reaching the cornea, affecting your vision, causing persistent discomfort, or has come back after previous surgery. Anything that looks irregular, rapidly changing or pigmented should be checked promptly to rule out other conditions.

This article is general information and is not a substitute for individual medical advice. Please see your optometrist to get a referral if you feel the pterygium is worsening, or starting to impact your vision.