Pterygium

What is a pterygium?

A pterygium is a fleshy overgrowth of the conjunctiva, which is the thin clear membrane on the surface of the eye.

About one in every 100 Australians develops a pterygium (the plural for pterygium is pterygia).

In most cases, a pterygium grows from the inner corner of the eye (nearest the nose). It may sometimes grow from the outer corner or on both sides of the eye at the same time.

One or both eyes may be affected.

The condition is not cancerous and does not invade the inside of the eye or spread to any other part of the face or body. It can look red and be mildly irritating.

If untreated, a pterygium may grow across the cornea (the transparent ‘window’ that covers the pupil and iris) affecting vision and becoming more obvious.

In this situation, surgical treatment may be required. Pterygia may grow back despite successful surgery.

Symptoms of a pterygium

A pterygium is usually painless, though it can cause irritation to the eye at any stage. The tissue is often triangular, pink and fleshy. Fine blood vessels may be visible.

If symptoms do occur, they may include:

• inflammation, including bloodshot whites of the eye on the side with the pterygium
• itching and burning sensations on the eye surface
• mild eye pain
• problems with vision if the pterygium grows across the cornea.

Risk factors for a pterygium

Pterygia are known to be associated with the following:

• Sunlight exposure – pterygia are more common in populations near the equator and in people who spend a lot of time outdoors in hot weather. Excessive exposure to the ultraviolet radiation in sunlight is thought to be the cause.
• Dusty or sandy environments – long-term exposure in dry and windy locations is thought to contribute to the development of the condition.
• Age – risk increases with age. Estimates suggest that about 12% of Australian men over 60 years have the condition.
• A combination of factors – pterygium may be caused by a number of the above factors working in combination.

Prevention of a pterygium

Protection of your eyes from the ultraviolet radiation in sunlight is always important. Wearing UV-protecting sunglasses and a wide brimmed hat may be beneficial in preventing the development or progression of a pterygium.

Diagnosis of a pterygium

A pterygium is diagnosed on its appearance. Generally, no other tests are needed.

An optometrist or ophthalmologist can confirm the diagnosis with a special microscope used to magnify the view of the eye.

If you think you have a pterygium, you should see your optometrist who may refer you to an ophthalmologist for further investigation or surgery.

Treatment for a pterygium

Treatment depends on the severity of the condition. Options may include:

• Protection against ultraviolet radiation – if the pterygium is small, painless and not causing vision problems, you may be advised to wear a hat and sunglasses when outdoors. Protecting the eyes from ultraviolet radiation tends to stop or slow down the pterygium’s growth. Wraparound sunglasses are recommended as they shield the eyes against ultraviolet light shining in from the sides of the face.
• Drops or ointments – to treat minor irritation or to lubricate and soothe the cornea. For severe inflammation, an eye specialist may prescribe a short course of steroid eye drops. These medications only ease symptoms and are not a cure.
• Surgery – is the only treatment that can remove a pterygium. Your optometrist may refer you to an ophthalmologist. It is preferable to remove the pterygium before it grows across the cornea and impacts your vision. Otherwise, it may scar the cornea and cause permanent vision problems. A pterygium can also be removed for cosmetic reasons.

The optometrist will check your pterygium every 1-2 years to make sure it is not increasing in size.

Where to get help

• Optometrist
• Ophthalmologist (your doctor or optometrist can refer you)