What is Pterygium? - Causes, Symptoms, Types and Prevention

Pterygium

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Pterygium

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Pterygium is a benign tissue growth that appears as a pinkish wing-shaped lesion on the cornea. It covers the sclera (the eye's white area) and extends over the cornea. Pterygium is also known as Surfer's Eye. 

People who live close to the equator are more likely to get pterygium. But anyone who lives in a warm climate is susceptible to developing it. It primarily affects individuals of the age group 20 to 40 years. It seems to affect men more frequently than women. Let’s read about Pterygium's representation of the pictures, symptoms, causes, types, diagnosis, prevention, treatment, and more.

Disease Name Pterygium
Alternative Name Surfer's Eye
Symptoms Redness, Blurred vision, Burning sensation, Irritation
Causes Ultraviolet rays, Dust, Wind
Diagnosis Photo documentation, Visual acuity test, Corneal topography
Treated by Ophthalmologist
Treatment options Pterygium surgery, Conjunctival autograft, Amniotic membrane grafting, Mitomycin C

What is Pterygium?

A Pterygium is a noncancerous growth starting at the conjunctiva, covering the sclera (the white area of the eye), and extending over the cornea. These wedge-shaped growths can occur in one eye or both. It is also called Surfer's Eye.

Pterygium Types

A pterygium does not always lead to vision impairment. But when it progresses to an advanced form, it can cause significant distortion in vision. Pterygium can broadly be categorised into two types:

  1. Progressive: It is thick, meaty, and vascular, which gradually spreads to the centre of the cornea.
  2. Atrophic: It is thin, poorly vascularised, and stagnant.

The factors that must be taken into consideration while evaluating a pterygium: 

  1. Location of the pterygium
  2. Size of pterygium
  3. The extent of the pterygium spread to the corneal region

Disease Progression of Pterygium

A pterygium does not always lead to vision impairment. But when it progresses to an advanced form, it can cause significant distortion in vision. The stages of pterygium are as follows:

  1. Stage 0: In this stage, the lesion is posterior to the limbus (border of the cornea in contact with the sclera). This stage is called Pinguecula, a yellow patch or bump on the conjunctiva. Fat, protein, or calcium deposition occurs on the tissue. 
  2. Stage 1: The lesion involves the limbus in this stage, and minimal papillary response is seen. 
  3. Stage 2: In this stage, the lesion appears just on the limbus, and minimal elevation is observed on the conjunctiva.
  4. Stage 3: In this stage, the head of the pterygium covers the area between the limbus and the papillary margin. The lesion is up to 1 mm.
  5. Stage 4: This is an extreme case where the pterygium is central to the papillary margin and extends more than 1 mm. As this stage involves areas of vision, it can lead to limitations in eye movement. 
Pterygium Types || image

Pterygium Symptoms

A pterygium can be removed if the symptoms are persisting and cause trouble. It is generally asymptomatic in the early stages, but when inflamed, it can produce burning, ripping, itching, and a feeling of a foreign body (gritty). It can cover the pupil and iris in its latter stages, impairing vision. The symptoms of pterygium include:

  1. Redness 
  2. Irritation
  3. Blurred vision
  4. Itchiness
  5. Burning sensation
  6. Gritty eyes

Pterygium Causes

The precise cause of pterygium is unknown. One explanation for these growths is excessive ultraviolet (UV) light exposure. People who live in warm regions and spend a lot of time outdoors in windy or sunny conditions are more likely to experience it. This disorder is more likely to affect those whose eyes are regularly exposed to particular elements. Below are some of the causes of pterygium that develops in a person:

  1. Dry eyes
  2. Excessive exposure to ultraviolet light 
  3. Irritants like wind, dust, smoke, and pollen

Pterygium Risk Factors

Pterygium is associated with several risk factors, including sun exposure, geographic latitude, ageing, nationality, and skin tone. The risk factors of pterygium fall into three categories:

  1. Demographic: Older age, males, and people with outdoor occupations
  2. Environmental: Exposure to sunlight
  3. Lifestyle: Cigarette smoking, alcohol consumption

Prevention of Pterygium

Pterygium might not always be completely avoidable. The chance of a pterygium developing can still be decreased, though. The following measures can be adopted to prevent a surfer’s eye formation or reduce the risk of a pterygium recurrence.

  1. Use sunglasses to block ultraviolet rays.
  2. Wear a hat whenever out in the sun.
  3. Avoid exposas much as possible exposure to environmental irritants such as smoke, dust, wind, and chemical pollutants
  4. Use appropriate eye safety equipment in the workplace.

How is Pterygium diagnosed?

The diagnosis of pterygium is made without the use of special tests. The ophthalmologist will use a slit lamp to perform a physical examination and diagnose the condition. A slit lamp consists of a microscope and a bright light that helps the doctor examine the eye. If the doctor needs to perform some additional tests, they may include:

  1. Photo Documentation: This test involves taking photographs of the patient’s eyes to track pterygium growth. 
  2. Visual Acuity Test: It consists of reading letters on a standardised eye chart. 
  3. Corneal Topography: This is a computer-assisted diagnostic test to measure the curvature changes in the cornea. 

How to prepare for the doctor's consultation?

  1. List down symptoms including any that may seem unrelated to the condition.
  2. List down the relevant events that may be related to the condition.
  3. The patient must tell the doctor the list of medications and supplements that he takes.
  4. The following questions should be asked the doctor:
    1. What treatment is best suitable for me?
    2. How can I stay comfortable in this condition?
    3. Do you think I have any other conditions?
    4. Do I need to see a specialist for my condition?
    5. Why is surgery needed?

Pterygium Treatment

If the patient has no significant troublesome symptoms of the pterygium, it may go away on its own. But, if the symptoms persist for a more extended period or more than a week, then the ophthalmologist may suggest one of the following treatment methods for pterygium.

Pterygium treatment without surgery

  1. For symptoms of dry eye, lubricants in the form of eye drops
  2. Spectacles for astigmatism that isn't very severe.
  3. Steroid eye drops for Pterygium that is inflamed.

Pterygium treatment with surgery

Pterygium surgery is advised in the following circumstances:

  1. The possibility of a progressive pterygium
  2. Periodic flare-ups of inflammation
  3. Double vision

Additional steps must be taken to prevent pterygium recurrence after simple surgical excision is done if needed. These include:

  1. Conjunctival Autograft: This procedure involves taking a small piece of conjunctiva from either the same or the opposite eye and transplanting it to the location where the pterygium was removed and left a defect. A conjunctival transplant provides normal stem cells to encourage normal conjunctival development.
  2. Amniotic Membrane Grafting: The amniotic membrane, the placenta's innermost layer, which surrounds the foetus, is taken from healthy, full-term caesarian babies. The membrane is then stretched over the region where the pterygium was removed after being trimmed to the correct size. The amniotic membrane is fixed in place using a specific adhesive or sutures. 
  3. Mitomycin C: This substance prevents growth at the conjunctival level, aiding in avoiding recurrences. It is either applied to the bed of the sclera after the pterygium is removed or given as eye drops following the procedure.
Surgery Name Surgery Cost
Pterygium Surgery ₹15,000 to ₹40,000

Risks and Complications of Pterygium

For minor pterygium cases, eye drops and ointment can usually treat inflammation. Only in the more severe cases does treatment involve surgical removal of pterygium. However, if left untreated, the growth can extend across the pupil, leading to:

  1. Scarring on the cornea
  2. Daily discomfort
  3. Vision loss
  4. Cosmetic concerns

When to see a doctor?

The patient can consult the doctor if he/she experiences:

  1. Redness 
  2. Irritation
  3. Blurred vision
  4. Itchiness
  5. Burning sensation

Diet for Pterygium

Changing dietary habits cannot treat pterygium. However, it can help reduce the risk of pterygium. Some of the below-mentioned dietary habits can help in preventing pterygium.

  1. Maintain a healthy diet: include plenty of vegetables, fruits and grains in the diet.
  2. Go organic: organic food items contain more nutrients and minerals that are essential for the body.
  3. Limit refined products: lower the amount of sugar and refined carbohydrates.
  4. Avoid fast food and fried foods: These items contain unwanted fats that can worsen the condition.
  5. Cut down caffeine intake (coffee), soft drinks and alcohol: These contain sugar that can increase the risk of a disease condition.

FAQs for Pterygium

What is pterygium and where does it develop?

A pterygium is a noncancerous growth starting at the conjunctiva, covering the sclera (the white area of the eye) and extending over the cornea.

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What is the best course of action for pterygium?

One can treat pterygium by the following methods: eye drops or creams that are available over-the-counter, eyedrops that lessen swelling and irritation, and steroid eyedrops are available by prescription to treat redness, irritation, swelling, and pain.

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How severe is a pterygium?

Pterygium may appear strange and even frightening, but it is not a dangerous condition of the eyes. You might not even need medical attention. Your eye discomfort can be relieved using artificial tears, steroid eye drops, or ointment. But if the symptoms persist for over a week, you must visit an ophthalmologist.

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Can pterygium disappear by itself?

A pterygium may stop growing or go away independently, although treatment is frequently required. Call immediately to make an appointment in the best hospital with HexaHealth if you notice a growth in your eye, feel itchy, red, or have vision problems.

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How quickly does pterygium develop?

It might continue to grow for a few months or years before stopping. It is more likely to impair your vision if it spreads and covers your cornea. Adults in their 20s to 40s are the most likely to develop these growths.

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How may a pterygium be stopped from growing further?

By protecting your eyes from sunshine, wind, and dust with sunglasses or a hat, you can lessen your risk of developing a pterygium. The sunglasses should also shield you from ultraviolet (UV) rays. Limiting your exposure to wind can help stop the growth of an existing pterygium.

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When should I go for the removal of pterygium?

The ophthalmologist's final recommendation is to have the patient's pterygium removed if it is large enough to be highly uncomfortable or to impair vision.

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Is pterygium capable of becoming cancer?

Pterygium are benign growths, not cancerous, which is essential to note. Thus, they won't spread to other areas of your body, even though they might develop locally (possibly impair your vision).

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How painful is pterygium surgery?

The pterygium is removed during surgery. It is replaced with a tissue transplant that is bonded in its place. The process is entirely painless, and there are no stitches.

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Is it possible to remove pterygium without surgery?

Pterygiums can be treated without surgery. Artificial tears that lubricate the eyes or mild steroid eye drops to reduce redness and swelling are typically used to treat smaller growths.

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How long does surgery for pterygium take?

A minimally invasive surgery lasts about 20 to 30 minutes. To lower the possibility of recurrence, the pterygium is first carefully peeled. Next, a tissue graft is extracted from behind your upper eyelid and applied over the removal site. Tissue glue is frequently used to keep the graft in place rather than stitches.

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Can pterygium be naturally treated?

You can also get rid of pterygium naturally by avoiding windy and dusty environments. Avoid working in a warm environment. Natural pterygium treatment involves making lifestyle adjustments, such as watching less television and spending more time on the computer. Splash cold water into your eyes a lot.

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How long does visual haze last following pterygium surgery?

Due to the cornea's curvature and altered eye prescription following surgery, vision may be hazy for several weeks. It might go away, but you might need to adjust your glasses.

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Does Insurance cover treatment for pterygium?

Yes, all health insurance plans cover the treatment for pterygium. Paperwork is facilitated by our team on your behalf ensuring smooth approval and a cashless facility. Contact HexaHealth for a simple cashless and hassle-free experience.

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How long do the stitches take to fall out following pterygium surgery?

The tissue adhesive disintegrates without leaving any trace after about a week, allowing the eye to heal painlessly. Tissue adhesive, made of clotting proteins typically present in human blood, enables the surgeon to secure a conjunctival autograft.

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What is the cost of pterygium surgery?

The cost of pterygium surgery is variable, considering the type of hospital chosen, the grade and stage of pterygium, the technique recommended, the patient's medical condition based on age and other health factors, etc. Contact HexaHealth for price transparency.

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What are the myths versus facts about pterygium?

  1. Myth: A pterygium is the same as a cataract.
    Fact: Pterygium is often confused with cataracts. However, these two conditions affect different parts of the eyes and develop for different reasons. A pterygium is an elevated growth that forms on the cornea whereas the cataract is a clouding of the eye's lens.
  2. Myth: Pterygium is just cosmetic and does not need to be removed.
    Fact: No, it is medically recommended to remove the pterygium to avoid symptoms like burning, itching, redness, tearing or a scratchy sensation.
  3. Myth: Pterygium surgery is painful.
    Fact: Surgery to remove pterygium takes about 30 minutes to complete. The eyes are numbed during the surgery thus a patient will not feel pain or discomfort during the surgery.
  4. Myth: Pterygium is always recurrent.
    Fact: Recurrence of pterygium is quite common, particularly in high-risk areas like warm climates. However, protecting the eye from the sun, dust and wind is also crucial to preventing the recurrence of a pterygium.
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Updated on : 6 April 2023

Reviewer

Dr. Aman Priya Khanna

Dr. Aman Priya Khanna

MBBS, DNB General Surgery, Fellowship in Minimal Access Surgery, FIAGES

12 Years Experience

Dr Aman Priya Khanna is a well-known General Surgeon, Proctologist and Bariatric Surgeon currently associated with HealthFort Clinic, Health First Multispecialty Clinic in Delhi. He has 12 years of experience in General Surgery and worke...View More

Author

Rajath R Prabhu

Rajath R Prabhu

MSc. Clinical Research I PG Diploma in Public Health Services Management

3 Years Experience

His work in medical content writing and proofreading is noteworthy. He has also contributed immensely to public health research and has authored four scientific manuscripts in international journals. He was assoc...View More

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