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Pterygium

What is a pterygium?

A pterygium is a benign, triangular growth of the conjunctiva onto the corneaThe cornea is the clear, transparent 'front window' of the eye through which light enters the eye. It handles about two-thirds of the focusing power of the eye and is critical for good vision. See Info on Eyes – Anatomy..  It usually occurs on the nasal aspect, and may occur in one or both eyes.  It receives nourishment from small blood vessels, which gives it a pinkish appearance.  In some cases, the pterygium grows across the central cornea over the pupil and causes a decrease in vision.  In order to prevent permanent damage to the cornea, it is often necessary to remove the lesion by surgical excision.

Symptoms

  • Redness
  • Irritation
  • Tearing
  • Difficulty with contact lens wear
  • Foreign body sensation
  • Decrease in vision

Causes

Excessive exposure to irritants, including:

  • UV exposure
  • Dust
  • Wind
  • Low humidity

Management

  • Medical treatment is aimed at alleviating symptoms, as it is not possible to remove a pterygium with medication.  Artificial tears are indicated to reduce irritation.  In some cases topical steroids are prescribed to reduce associated inflammation.  It is beneficial to wear eye protection like sunglasses and a hat, which may prevent further growth of the pterygium.
  • The only way to get rid of the lesion, is by surgical removal.
  • The surgical removal of a pterygium is done in a general theatre setup under local anesthetic as a day procedure.  It is important to note that the eye is often highly irritated, red and uncomfortable during the first few days/weeks following surgery.  Eye drops are administered in the early post-operative period to prevent infection and alleviate these symptoms until the eye has stabilized.  During this time it is very important to protect the eye from UV light, wind and dust, and keep it moist with artificial tear supplements.
  • It is possible for a pterygium to recur after surgical removal.  Beta irradiation by radio-active Strontium 99 of the area and the wearing eye protection, reduces the risk of recurrence.  To prevent recurrence, irradiation is almost done routinely at the time of surgery, as well as one week post-operatively.