A Pterygium is a triangular fold of benign growth of tissue on the white of the eye (sclera) that can eventually grow over part of the cornea. It is associated with and thought to be caused by ultraviolet-light exposure (e.g., sunlight), low humidity and dust. Additionally, pterygia are twice as likely to occur in men as women. It is a wide-spread problem in our area due to the continuous and strong exposure to UV light. The more time the person spends doing outdoor activities, the higher the chance of developing the disease.

Some people have no symptoms, while others may experience persistent redness, inflammation, foreign body sensation or dry and itchy eyes. Pterygia that are chronically inflamed can become itchy. In advanced cases, the pterygium can affect vision, as it invades the cornea with the potential of induced astigmatism and corneal scarring. Because a pterygium resembles tissue or film growing over the eye, a person who has one may become concerned about personal appearance. Additionally, a pterygium that stays over the cornea for an extended period of time starts to leak lipids inside the cornea, creating white spots that also affect the eye appearance.

Treatment depends on the pterygium’s size and the symptoms it causes. If a pterygium is small, but becomes inflamed, I would prescribe lubricants or possibly a mild steroid eye drop to reduce swelling and redness. In more severe or chronic cases, it may be necessary to remove it surgically.

The surgical procedure involves a topical anesthetic with sedation that will be used before surgery to deaden feeling in your eye’s surface. Your eyelids will be kept open with an eyelid speculum while the pterygium is surgically removed. Personally, I use the conjunctival auto-grafting surgical technique. This is an effective and safe procedure for pterygium removal. When the pterygium is removed the tissue that covers the sclera -- known as the conjunctiva -- is also extracted. The autograph replaces the bare sclera with tissue that is surgically removed from the inside of the patient’s upper eyelid. That “self-tissue” is fixated using tissue adhesive instead of sutures for a faster and more painless recovery. The “human” glue used during the surgery is derived from blood coagulation products, including fibrinogen, which is converted to fibrin when in contact with the patient’s blood thrombin. The characteristics of fibrin make it “glue” tissues temporarily up to 48 hours, after which is reabsorbed without a trace. Cosmetically, after the procedure, it is difficult to elicit any previous surgery, and the eye looks calm and white without irritation.

After the procedure, which usually lasts no longer than half an hour, you will probably need to wear an eye patch for protection for a day. You should be able to return to work and other normal activities the next day.

A drug that slows metabolic processes (antimetabolite) contributing to tissue growth, such as mitomycin, may be applied topically in selected cases.

The risk of recurrence varies depending on the surgical approach. To prevent re-growth after the pterygium is surgically removed, I use a technique where I glue a graft of the patient’s own tissue onto the affected area. This graft fills the space where the abnormal tissue would have re-grown, thus having a low recurrence rate (less than 5 percent) instead of the original rate of up to 50 percent.

After removal of the pterygium, steroid eye drops may be used for several weeks to decrease swelling and prevent re-growth.

Since pterygium development is associated with excessive sun or wind exposure, wearing protective sunglasses with side shields and/or wide brimmed hats and using artificial tears throughout the day may help prevent their formation or stop further growth. Surfers and other water-sport athletes should wear eye protection that blocks 100 percent of the UV rays from the water, as is often used by snow-sport athletes.

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