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Pterygium article

A pterygium (pronounced “te-ridge-e-um”) is a benign growth of tissue on the surface of the eye.  It starts as redness and thickening in the corner of the eye – usually the corner closest to the nose. The growth can extend across the surface of the eye towards the iris (the coloured part of the eye). This growth is often triangular in shape and, if left untreated, can extend across the pupil obscuring vision, or causing the surface of the eye to alter shape and “warp” resulting in blurring of the vision. 

PTERYGIUM

Exposure to excessive amounts of ultra-violet light is thought to be the most significant factor in the development of a pterygium.  Pterygia are more common in people living in sunny areas and in people whose jobs expose them to ultra-violet light (eg: farmers, arc welders).

Other factors that may play a role in the development of pterygia include environmental irritants (eg: wind, chemicals, air pollution) and hereditary factors.

Signs and Symptoms


Often a person may notice the formation of a pterygium but may not experience any other symptoms.  If other symptoms are experienced, they may include:    

 

  • Eye redness and inflammation.
  • A gritty feeling in the eye.
  • A feeling that there is a foreign object in the eye.
  • Dryness of the eye due to reduced tear production.
  • Blurring of vision if corneal surface is altered or “warped”.
  • Obscuring of vision if growth encroaches across pupil.

Diagnosis


A pterygium can usually be diagnosed by its distinctive appearance and symptoms.  However, in the early stages it may be confused with similar conditions such as pinguecula. 

 

Treatment

Treatment depends on the size and nature of the pterygium, the symptoms and whether vision is affected.  There are two main ways a pterygium can be treated.

Medication

Eye drops may be used to reduce redness and irritation. Where dryness of the eye is a problem, artificial tears are used to keep the eye well lubricated.

Surgery

Surgery may be recommended when vision is affected or symptoms are particularly problematic or for cosmesis.

1. pterygium excision without graft

- this procedure just remove the pterygium out but without conjunctival graft .

- the cost is cheap but the risk of recurrence is about 50%.

2. pterygium excision with conjunctival graft

- this procedure we use the conjunctiva to cover the area that we remove the pterygium out.

- the risk of recurrence is about 15%.

3. pterygium excision with amniotic graft

- this procedure we use the amniotic graft to cover the area that we remove the pterygium out.

- the risk of recurrence is about 10% and the eye is less inflammed.

Surgery is performed using a local anaesthetic and takes approximately 30 minutes to perform.We can do as outpatient and do not close the patient's eyes. It is possible for pterygia to recur after surgical removal even with the best one so the patient need to protect their eyes with sunglasses when outdoors.

Prevention


In order to prevent pterygia forming, or to reduce the risk of a pterygium recurring, the following measures are recommended:  

  • Use sunglasses that block out ultra-violet light (close-fitting, wrap around styles are best).
  • Wear sunglasses and a hat when outdoors.
  • Avoid exposure to environmental irritants eg: smoke, wind and chemical pollutants.
  • Use appropriate eye safety equipment in work environments.

 

 



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