Pterygium Surgery

A pterygium (pronounced ter-IJ-ee-um) is a raised, fleshy growth that forms on the conjunctiva — the clear tissue covering the white part of the eye. It often appears whitish or pink and may contain visible blood vessels. A pterygium usually begins at the inner corner of the eye and can slowly grow toward the iris, the coloured part of the eye.

It is more common in older adults due to long-term exposure to environmental factors such UV light, day weather, and in people who live closer to the equator where ultraviolet (UV) light exposure is stronger.

A pterygium is a non-cancerous growth and does not spread to other tissues. However, it can continue to grow across the surface of the eye. If it extends onto the cornea — the clear front surface of the eye — it may affect vision. In cases where vision is threatened or symptoms are significant, surgical removal may be recommended.

A pterygium is caused by an overgrowth of conjunctival tissue. Contributing factors include:

• Long-term exposure to ultraviolet (UV) light
• Chronic irritation from dry, hot climates, wind, and dust

Other possible risk factors include:

• Age over 60
• Family history (genetics)
• Vitamin A deficiency
• Human papillomavirus (HPV)

In the early stages, a pterygium may cause no symptoms and may only be noticed as a small, raised, wedge-shaped growth on the eye. As it progresses, symptoms can range from mild to more noticeable and may include:

• Redness or bloodshot appearance
• Inflammation or swelling
• Dry or watery eyes
• A gritty or foreign body sensation
• Itching or burning
• Eye discomfort or pain

Over time, some people may also experience:

• Growth or spread of the lesion
• Discomfort when wearing contact lenses
• Changes in vision, such as blurred or double vision

Not everyone with a pterygium experiences symptoms, and the rate of growth can vary from person to person.

Treatment for a pterygium depends on how much it is affecting you. If it isn’t causing symptoms, treatment may not be necessary. Your eye care provider will monitor it during regular eye examinations to check its growth and ensure it isn’t affecting your vision.

If the pterygium causes irritation or discomfort, your provider may recommend:

• Over-the-counter lubricating eye drops or ointments
• A short course of steroid eye drops for more severe inflammation

Protecting your eyes from further sun exposure is also important. Wearing a hat and wraparound sunglasses with UV protection can help reduce irritation and may slow the growth of the pterygium. If the growth begins to extend toward the cornea, surgery may be recommended before vision is affected.

The only way to permanently remove a pterygium is with surgery. It will not go away on its own. Surgery may be recommended if the pterygium is causing significant irritation, growing quickly, affecting vision, or for cosmetic reasons.

Pterygium surgery is performed by an ophthalmologist. Pterygium surgery is usually done as an day surgery procedure, meaning you can return home the same day. 

During the procedure, the ophthalmologist will:

• Remove the abnormal tissue from the surface of the eye
• Cover the exposed area of the conjunctiva with healthy tissue called conjunctival autograft. 
• Conjunctival autograft: Healthy conjunctival tissue is taken from another area of your eye, usually from behind the upper eyelid, and used to cover the area. This donor site is well protected and typically heals on its own.

The procedure usually takes about one hour. After surgery, you may need to wear an eye patch for a few days. Complete healing generally takes four to six weeks.

Your eye care provider will prescribe medications to use at home, including antibiotic drops to prevent infection and steroid eye drops to reduce inflammation and lower the risk of the pterygium returning.

There is a small chance that a pterygium may return after surgery. If recurrence does occur, it usually happens within the first four months and rarely later than 12 months after the procedure. If further surgery is needed, your surgeon can use additional techniques to reduce the risk of the pterygium coming back again.