Pterygium FAQs


What is a Pterygium?
What causes a Pterygium to form?
What symptoms would i have from a Pterygium?
What is the treatment for a Pterygium?
How do you prevent Pterygium?
When should a Pterygium be surgically removed?
What is involved in the surgical removal of a Pterygium?


WHAT IS A PTERYGIUM?
A pterygium is a wedge-shaped fibrovascular growth of conjunctiva (the surface tissue of the white of the eye) that extends onto the cornea. Pterygia are benign lesions that can be found on either side of the cornea.

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WHAT CAUSES A PTERYGIUM TO FORM?
It is thought that prolonged exposure to ultraviolet light may contribute to the formation of pterygia. Pterygia are more often seen in people from tropical climates, but can be found in others as well.

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WHAT SYMPTOMS WOULD I HAVE FROM A PTERYGIUM?
In most cases, routine ocular evaluation reveals pterygia in asymptomatic individuals or in patients who present with cosmetic concern about a tissue "growing over the eye." In some instances, the vascularized pterygium may become red and inflamed, motivating the patient to seek immediate care. In other cases, the irregular ocular surface can interfere with the stability of the precorneal tear film, creating a symptomatic dry eye. Rarely, the pterygium may induce irregular corneal warpage, or even obscure the visual axis of the eye, resulting in diminished acuity.

Clinical inspection of pterygia reveals a raised, whitish, triangular wedge of fibrovascular tissue, whose base lies within the interpalpebral conjunctiva and whose apex encroaches the cornea. The leading edge of this tissue often displays a fine, reddish-brown iron deposition line (Stocker's line).

The vast majority of pterygia (about 90 percent) are located nasally. These lesions are more commonly encountered in warm, dry climates, or in patients who are chronically exposed to outdoor elements or smoky/dusty environments.

Pterygia must be distinguished from pingueculae, which are more yellow in color and lie within the interpalpebral space but generally do not encroach beyond the limbus. Pingueculae also lack the wing-shaped appearance of pterygia, the former being more oval or ameboid in appearance.

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WHAT IS THE TREATMENT FOR A PTERYGIUM?
This depends largely on the size and extent of the pterygium, as well as its tendency for recurrent inflammation. Evaluation by an ophthalmologist will help determine the most optimal treatment in each case. If a pterygium is small but becomes intermittently inflammed, your ophthalmologist may recommend a trial of eye drops during acute inflammatory flares. If these drops are recommended, you should remain under the care of your ophthalmologist to ensure that you do not develop side effects from the use of these medications. In some cases, your ophthalmologist may recommend surgical removal of the tissue.

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HOW DO YOU PREVENT PTERYGIUM?
The best method of preventing pterygium is to regularly wear UV 400 rated sunglasses when outdoors in sunny conditions. Sunglasses with a wrap-around design provide better protection than those with large gaps between the sunglass frame and the skin around the eyes. Wearing a hat with a wide brim provides valuable additional protection.

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PterygiumWHEN SHOULD A PTERYGIUM BE SURGICALLY REMOVED?
This will depend largely on the judgment of your physician. Removal will likely be advised if the pterygium is growing far enough onto the cornea to threaten your line of vision. Pterygia may also be removed if they cause a persistent foreign body sensation in the eye, or if they are constantly inflammed and irritating. In addition, some pterygia grow onto the cornea in such a way that they pull on the surface of the cornea and change the refractive properties of the eye, causing astigmatism. Removing the pterygium may decrease the astigmatism.

WHAT IS INVOLVED IN A SURGICAL REMOVAL OF A PTERYGIUM?
The removal may take place in a procedure room or operating room setting. The pterygium is carefully dissected away. In order to prevent regrowth of the pterygium, your ophthalmologist may remove some of the surface tissue of the same eye (conjunctiva) and suture it into the bed of the excised pterygium. Alternatively, an antimetabolite such as mitomycin may be applied to the site. Postoperatively, your ophthalmologist may recommend some eye drops for several weeks to decrease the inflammation and prevent regrowth of the pterygium.

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