What is a Pterygium?
A Pterygium is a benign or non-cancerous growth of conjunctival tissue (outer layer of tissue covering the white part of the eye containing many blood vessels) onto the cornea (clear portion of the front of the eye). It usually grows from the nasal side of the eye but can also occur on the temporal side or in rare circumstances from both sides. It may occur in one or both eyes.
What Causes a Pterygium?
It is believed that exposure to sunlight, wind, sand, dirt, and dry conditions cause pterygiums to proliferate or grow on the surface of the eye. It occurs more commonly in people near the equator with higher sun exposure. Farmers, commercial fishermen, tennis players, and those who work or play outdoors develop pterygiums.
Symptoms of Pterygiums
Foreign body sensation
Blurred vision as the pterygium approaches the pupil area of the cornea causing astigmatism and blurred vision when it gets in the pupil area of the cornea due to the opaque tissue
Prevention of Pterygiums
As it is felt that sun and wind play a significant role, wearing wrap around type sunglasses and using artificial tears can help prevent and/or stop the progression of pterygium growth.
Treatment of Pterygiums
There are a number of different options available for treatment of pterygiums. It is not necessary to remove the pterygium unless it gets near the pupil and is going to start causing visual problems. If they become painful and medical treatment to calm down the inflamed pterygium does not work, removal may be done to alleviate the pain.
Surgical removal is the primary form of treatment. In many cases if that is all that is done, many times they will reoccur. Others treatments or techniques are added to the removal to help insure that the pterygium does not return.
Many doctors use a cancer type drug Mitomycin-C. It can be applied to the area of surgery for a few minutes after the pterygium is removed. The conjunctiva is then sutured back in place. Also, the Mitomycin-C can be used as an eye drop for a period of time after the surgery.
A conjunctival auto-graft can be used during the operation to help prevent reoccurrence. Once the pterygium is removed the opened area is covered with a graft of conjunctiva from the upper or lower portion of the eye where the conjunctiva has not been exposed to the environment. This is sutured into place using stitches or glue adhesive.
An amniotic membrane transplantation can be used to cover the exposed area of the sclera (white portion of the eye). The amniotic membrane is acquired from the innermost layer of the human placenta and preserved. The amniotic membrane can be sutured or glued into place.
Beta radiation can be applied after surgery in cases that reoccur and other treatments have not worked.
After removal of the pterygium, the eye will be sore or painful until the eye has had time to heal. Patients will be placed on eye drop medications to help with the healing process.
Most people do not need surgery for pterygiums. For more advanced cases that do need surgery most people will do very well. It is important that even after removal patients should protect their eye from the sun, wind, and use artificial tears.