Pterygium

A pterygium is a form of scar tissue with blood vessels, which grows towards the cornea and then into the cornea. It can be a source of irritation and redness, which can flare up from time to time.  It can also be a cosmetic problem, and, occasionally, it can lead to visual distortion by altering corneal shape. In doing this, it can cause irregular corneal astigmatism. For a pterygium to become bad enough to cause visual distortion is unusual, as they mostly never proceed to this level. Sometimes a pterygium can be confused with a type of low grade skin cancer, which can look a little like a pterygium.

The best way to prevent a pterygium occurring is to wear sun glasses and a hat.  If you already have a pterygium this is also the best way to prevent it growing larger.

How is a pterygium treated?

In most cases, a pterygium is better off without surgery. You can use local decongestant drops to make the eye less red, and use artificial tear drops to make the eye more comfortable when it flares up.  If this is enough to remain comfortable and cosmetically acceptable, then surgery is not necessary.

Surgery for pterygium

If surgery is required, the pterygium needs to be removed. The problem with simply removing a pterygium is that there is a fairly high recurrence rate. Traditionally the pterygium would be removed, then low dose Beta irradiation would be applied to the excised area, and this tended to reduce the recurrence rate considerably. This is still a worthwhile thing to do, as long as the dosage rate is controlled.  However, mostly a conjunctival graft (either a free graft or pedicle graft from elsewhere on the surface of the eye) is used in order to repair the area from which the pterygium has been removed. This tends to have a fairly low recurrence rate, and also tends to be cosmetically quite good, as the area is replaced with healthier conjunctival tissue.

The surgery is performed under local anaesthetic either with drops and/or an injection, and is performed as a day only procedure. Your eye will tend to be red and irritable for three to four weeks after surgery, and drops are used during this period. Occasionally after a pterygium is removed, there can be scarring at the site of excision, and this will sometimes need to be lasered to remove the scarring and smooth the cornea.