What is a Pterygium?

A pterygium (often called a “fleshy growth”) is an abnormal growth of tissue from the conjunctiva (the clear membrane covering the white part of the eye) that extends and grows onto the cornea (the clear window of the eye).

Pterygium is directly associated with chronic exposure to ultraviolet (UV) light, dust, wind, and dry environments. It is more common in people who live near the equator or who spend a lot of time outdoors.

Symptoms and Risks

A pterygium can cause discomfort and, if left untreated, impair vision:

Irritation and Redness: Chronic symptoms, foreign body sensation, itching, and burning.

Dry Eyes: Tears are not distributed properly across the surface of the eye.

Blurred Vision: If the pterygium is large, it can obstruct the central visual axis. Even if small, it can induce or worsen astigmatism by changing the shape of the cornea.

Treatments and Management

The management of a pterygium depends on its size, the symptoms it causes, and the risk it poses to vision:

1. Medical (Conservative) Treatment

Lubrication: Frequent use of artificial tears to relieve irritation and dryness, especially in the initial stages or when irritation is mild.

Anti-inflammatory Drops: Use of steroid or non-steroidal anti-inflammatory eye drops (under medical supervision) to control redness and swelling during flare-ups.

UV Protection: Consistent use of high-quality UV-protective sunglasses (especially outdoors) is the most important preventive measure to avoid its growth.

2. Pterygium Surgery (Excision)

Surgery is recommended when the pterygium:

Begins to obstruct the central visual axis or induces significant astigmatism.
Causes chronic irritation that does not improve with medication.
Creates a significant cosmetic problem.

Conjunctival Autograft Technique: This is the gold standard. It involves completely removing the pterygium and replacing the exposed area of ​​the conjunctiva with a small graft of healthy tissue (conjunctiva) taken from the patient’s own eye (usually from under the upper eyelid).

Advantages: This technique significantly reduces the risk of the pterygium growing back (recurrence), which is the main challenge of this surgery.

Use of Adjuvants: Medications such as mitomycin C or beta radiation therapy may be used in cases of high risk of recurrence, although the autograft is usually sufficient.

Who is a good candidate for surgery?

You are a good candidate for pterygium surgery if:

Your pterygium has grown beyond the periphery and is moving toward the center of the cornea.

You experience blurred vision or increased astigmatism due to its growth.

Chronic symptoms of redness and irritation are not controlled with eye drops.

What to expect during the procedure?

Preoperative Evaluation: Detailed measurements of the pterygium’s size will be taken, and its impact on the cornea will be determined using corneal topography.

During Surgery: The procedure is outpatient, performed under local anesthesia with sedation, and generally lasts between 30 and 45 minutes. The surgeon uses very fine sutures or fibrin glue to secure the autograft.

Postoperative Recovery: The eye will be red and swollen for the first few weeks. Strict use of anti-inflammatory and antibiotic eye drops is crucial. The graft takes several weeks to fully integrate, but most patients return to their normal activities (avoiding strenuous physical activity and sun exposure) within 1 to 2 weeks.