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Pterygium: A growth on the conjunctiva

What is pterygium?

Pterygium refers to a triangular tissue growth that starts from the conjunctiva of the eyes. The word “pterygium” in Greek means “wing”. Such growth covers the sclera and extends onto the cornea. These growths are superficial and may remain small or interfere with vision when they grow. Such growths are noncancerous and may occur in one or both the eyes. If the pterygium is not treated, it might interfere with vision.  Pterygium is common in warm and dry climates. Typical onset of pterygium is between 20 and 30 years of age and male preponderance is present.

Pterygium: A growth on the conjunctiva

Causes

The precise cause of pterygium is not known. Pterygia incidences are seen in  individuals who have:

  • Long-term exposure to sunlight, particularly Ultraviolet radiations (UV-rays)
  • Family history- People with autosomal dominant trait are more prone to develop pterygium
  • Countries which are closer to equator show a greater preponderance to develop pterygium- This is due to their exposure to UV- B rays
  • Long-term exposure to dust and working outdoors in dry conditions are thought to cause pterygia.

Pterygium symptoms include:

Symptoms And Signs

  • Burning and itching 
  • Excessive flow of tears
  • Formation of pink, red, or white raised lesion on the eye
  • Irritation and redness of eye
  •  Blurring of vision
  • Decrease in vision
  • Foreign-body sensation in the eye

Such symptoms do not necessarily mean one has pterygium. However, one must visit their ophthalmologist on encountering any or more of such symptoms.

Diagnosis

No special examination or tests are needed. Pterygia may be detected during routine physical examination of the eyes and eyelids. 

Treatment

In many cases where pterygia do not cause any problems, treatment is not required. Inflammation of pterygium may be prevented by use of artificial tears. Inflammation can be treated by the of mild steroidal eyedrops or ointments.

Pterygium: A growth on the conjunctiva

In people with early-stage pterygium due to UV rays, wearing of protective eye-gear is recommended.

If the pterygium persists to irritate, interferes with vision or for any cosmetic reasons, surgery (removal of the pterygium) might be performed.

Prevention

Measures aimed at protecting the eyes from UV light might be helpful in preventing pterygia. These could be wearing hats with brim and use of sunglasses. 

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Complications

Complications include redness, double vision, decreased vision, scarring of the conjunctiva, cornea and eye muscles. Continued inflammation may lead the pterygium to extend onto the cornea further.

Postoperative complications include- infection, double vision (diplopia), scarring of the conjunctiva, retinal detachment, vitreous haemorrhage.

Most common complication post-surgery is the recurrence of pterygium. Treatment is medications with surgery.

Next steps

Individuals suffering from pterygium must visit their ophthalmologist for annual eye checkups. This aids in timely treatment before the pterygium affects vision.

Red Flags

Visit your ophthalmologist

  • If you have had one incidence of pterygium earlier and notice reoccurrence of symptoms which are not relieved by conservative treatment.
  • If pterygium is extending into your cornea and obstructing your vision
  • If the pterygium is appearing unsightly

Consult a top Ophthalmologist

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References

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  • Foundations of Clinical Ophthalmology. 2013 ed. Philadelphia, PA: 2013:vol 2; chap 112. Pinguecula and Pterygium (Surfer’s Eye)
  • Diagnosis and Treatment. American Academy of Ophthalmology. Accessed 25 Feb. 16. http://www.aao.org/eye-health/tips-prevention/pinguecula-pterygium-diagnosis-treatment
  • Pterygium. NLM-NIH. Medline Plus. Accessed 25 Feb. 16. https://www.nlm.nih.gov/medlineplus/ency/article/001011.htm
  • Pterygium. University of Michigan Kellogg Eye Center. Accessed 25 Feb. 16. http://www.kellogg.umich.edu/patientcare/conditions/pterygium.html

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