07 Aug What is pterygium?
A conjuctival pterygium, also known as surfer’s eye, is a triangular, fleshy, non-cancerous growth. It is thought to be a fibrous and vascular proliferation from the mucosal tissues that line the front of the eyes and eyelids onto the clear protective outer layer of the eye known as the cornea. [1] It develops on the cornea of the eye typically arising in the area near the nose. A pterygium is usually slow growing but if untreated can occasionally grow large enough to cover the pupil.
Pterygium may be mistaken for other conditions such as Terrien’s marginal corneal degeneration and pinguecula.
How common is it?
Globally, pterygium has a prevalence of 10.2%. It is most commonly encountered in the regions known as the pterygium belt’ which includes the tropics and equatorial zones. Countries such as Australia, India, Barbados and the United States see relatively high incidences.
What causes pterygium?
The cause of this condition remains unclear but its geographic distribution points to a number of contributing factors including prolonged UV light exposure and exposure to wind, sand and dust.
Pterygium is more common in men and those with outdoor occupations which strengthens the hypothesis that sunlight exposure is a critical driver of pterygium development. [2] It is also known as surfer’s eye.
This is a degenerative condition with these exposures perhaps accelerating collagen breakdown in the conjunctiva with proliferation of new fibrous and vascular tissues. The way in which UV light is focused on the eye is also thought to be responsible for the nasal predominance of pterygium [3].
Key signs and symptoms
Patients may complain of red or dry eyes or in the case of late disease progress, present with some sight loss. The eye lesion is usually pink or pale depending on the level of vascularity present and may show iron deposits along the direction of growth known as stocker’s Line.
How is pterygium treated?
Treatment is usually conservative including interventions aimed at reducing exposure to sunlight and irritants and keeping the outer surface of the eye moist. Methods include:
- artificial tears
- sunglasses and eye protection [2]
Surgical treatment is usually only necessitated by visual loss, a cosmetically significant lesion or a pterygium that affects eye movements or contact lens wearing. The surgery is excision removal with autografting to cover the exposed deeper layers of the eye. The procedure offers good results with a low recurrence rate post operatively. [3]
Preventing recurrence
Given the strong geographic pattern of distribution of pterygium and its risk factors health promotion can make great impact in preventing this condition. Stressing the importance of eye production and avoidance of prolonged sunlight exposure is key.
This article is not a substitute for a consultation with your surgeon. Before choosing to proceed with laser eye surgery your surgeon will have a detailed discussion with you about the right procedure and about the potential complications.
References
1.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5968422/
2.https://www.aao.org/topic-detail/pterygium-latin-america
3.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC504636/
A unique mix of expertise, experience and international reputation, Dr Ron Binetter is the figure behind the Binetter Eye Centre. With more than two decades of hands-on experience in eye surgery, Dr Binetter is a specialist in cataract, lens implantation and laser eye surgery. Learn more about Dr Ron Binetter’s background and qualifications.