Pterygium is a triangular shaped fold of conjunctiva (the thin usually clear membrane over the white of the eye) which has grown, together with fibrous tissue and blood vessels into the adjacent cornea.
Pterygium typically arises from the inner (nasal) conjunctiva and is strongly associated with ultraviolet light (UV) exposure. Hence pterygia usually occur in patients living in hot climates such as the Indian sub-continent, Africa and Australia.
This photo shows a pterygium with an associated, elevated, conjunctival cyst.
Other factors such as dryness, inflammation and exposure to dust, may also play a role.
Pterygium may not cause any problems. However, patients typically complain of:
- Irritation or grittiness
- Intermittent inflammation and redness
- Unsightly appearance
- Blurred vision by causing astigmatism, or by obscuring the line of sight as they advance centrally over the cornea
In the early stages of the condition, simple regular lubricants may suffice. Vision may be improved with spectacles.
When the above options are not sufficient, then surgery may be warranted. This involves careful removal of the pterygium from the cornea and adjacent nasal conjunctiva. In order to reduce the chances of recurrence, we usually repair the defect created by the excision, with an area of healthy conjunctiva taken from the same eye, under the upper eyelid. This is known as a conjunctival autograft. With our more advanced techniques, we are able to do this repair using special “tissue glue” and thus without the need for stitches.
The surgery is carried out under local anaesthetic, often with the help of intravenous sedation (twilight anaesthesia). Patients can thus be discharged home the same day, with a pad over the eye, until the following morning.
After the procedure is completed, you will be given a full explanation regarding post-operative drops and tablets and follow up care. A protective eye shield will have been placed over the treated eye to prevent you from rubbing your eye for the rest of the day and also whilst sleeping during the night.
During the early post-operative period it is important not to squeeze or rub the eyes. Antibiotic and anti-inflammatory drops are used to prevent infection and decrease inflammation.
Follow-up appointments typically take place after 1-2 weeks and again 6-8 weeks later.
Can surgery be avoided?
In early stages of the condition lubricant drops alone may be sufficient to deal with the symptoms.
Is the procedure painful?
The procedure is carried out under local anaesthetic (often with the aid of sedation) and hence is not painful. The initial post-operative period can, however, be quite uncomfortable. You will be given painkillers to help you through this short period.
Will I need time off work?
You would be advised to take 1-2 weeks off work. Sometimes it may be possible to work from home during this period.
Will my vision be affected?
The presence of pterygium can cause problems with focussing, by causing astigmatism to develop. Similarly, removal of pterygium may alter the focussing and hence you would be advised to see your optician about 6 weeks following surgery. Your surgeon will discuss this with you, following your surgery.