Pterygium and Pingueculum

Pterygium and Pingueculum

A pterygium is a wing-shaped fleshy overgrowth on the surface of your eye. This can eventually extend onto the surface of your cornea, which is the clear front window of your eye. A pterygium can cause ocular irritation, particularly in hot and windy conditions, and it can also cause a change in your vision. In most cases, a pterygium grows from the inner corner of the eye closest to your nose, although it can also grow from the outer corner as well. It can affect one or both eyes.

It affects approximately 1 in every 100 Australian, although this increases with age.

In the early stages, patients may not have any symptoms. However, as a pterygium grows and/or becomes inflamed, patients can experience:

·       Dryness / burning

·       Grittiness / discomfort

·       Excessive watering

·       Red eyes

·       Light sensitivity

·       Blurry or distorted vision

·       Dissatisfaction with the appearance of their eye

What causes a pterygium?

Risk factors for pterygium include:

  • Sunlight exposure – people who live near the equator and spend a lot of time outdoors in hot weather are more likely to develop a pterygium due to increased UV light exposure.
  • Dusty and windy environments – long-term exposure can contribute to its development.
  • Age – it becomes more common as we age. 1 in 10 Australian men aged over 60 have one.

Treatment options

Patients do not require any surgery if the pterygium is small and they are not troubled by any symptoms. However, in some cases, surgery may still be warranted if there are sinister features to suggest a potential transformation to a cancerous process (called ‘dysplasia’); this is uncommon.

  1. Prevention of further progression: Minimise UV exposure by wearing a broad-brimmed hat and wrap-around sunglasses.
  2. Eye drops: Regular use of lubricating eye drops (such as Hylo-forte®) can help relieve ocular discomfort caused by the pterygium. A short course of topical steroids may be prescribed if your pterygium becomes inflamed.
  3. Surgery: This is indicated when your vision becomes affected, or if you are experiencing ongoing discomfort. This may also be required when there is concern about the pterygium transforming to an early cancerous process (called ‘dysplasia’). You may also wish to have the pterygium removed because you do not like its appearance.

Pterygium surgery – expectations and potential risks

Pterygium surgery is a day procedure, and is commonly performed under local anaesthesia. The pterygium is removed, and a conjunctival graft (similar to a thin clear membrane) is harvested from the outer surface of your eye and sutured into place to decrease the potential recurrence of the pterygium. The eye is often quite uncomfortable for the first few days following surgery, but this will settle down once the eye starts to heal and the sutures dissolve.

There is a small chance that the pterygium can grow back, and your vision may change depending on the effect that the pterygium had on your cornea prior to surgery. Infection is a risk with any eye surgery, so you will be given antibiotic eye drops and care instructions for your eye following surgery.

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