Although often called surfers’ eye, a pterygium does not only occur in surfers, but is a common complaint that can affect anyone who spends a lot of time outdoors exposed to the sun and wind. A pterygium is a benign wedge-shaped growth that develops on the conjunctiva, the clear membrane that covers the front surface of the eye.
Sometimes associated with a pterygium is a pinguecula, a yellowish raised growth on the conjunctiva. While they may appear similar and have similar causes, these are different conditions. A pterygium is a fleshy growth that contains blood vessels, whereas a pinguecula is a deposit of fat, protein or calcium. Sometimes, a pinguecula can develop into a pterygium. As the growth becomes larger, it develops its own blood supply which causes it to become more bothersome and take on a pink or reddish colour.
Both conditions typically form in one or both eyes on the inner corner of the eye closest to the nose and grow towards the pupil. They generally spread slowly over time, without any symptoms, but if there are symptoms, they are usually mild. Common symptoms include eye redness, dryness, irritation, burning, itching, tearing and a gritty sensation. In rare cases a pterygium can cover the pupil and cause vision problems.
The exact cause is unknown, but pterygium and pinguecula are believed to be caused by exposure to UV light as well as wind, dust, smoke and other irritants. They occur more often in people who live in warm dry climates and spend a lot of time outdoors in sunny or windy environments. Some studies suggest that genetics have a role to play in their development and note that although UV exposure is a factor, even people who have low UV exposure can develop pterygia. Likewise, some people who have high UV exposure may never develop the condition.
An optometrist may diagnose a pterygium based on a physical examination using a slit lamp, which allows him or her to examine the eye with the help of magnification and bright lighting.
Additional tests may include a visual acuity test, corneal topography to measure changes in the cornea, and photographic documentation to track the rate of growth of the pterygium.
Unless it is interfering with vision or causing severe discomfort, a pterygium usually does not require treatment. The optometrist may suggest symptomatic treatment such as eyedrops to lubricate the eyes and relieve dryness and irritation or steroid eyedrops to reduce inflammation and ease redness, itching and swelling. If contact lenses have become uncomfortable or are contributing to the eye irritation, it may be necessary to have a break from them and wear glasses until the symptoms have eased. Regular eye examinations are important to monitor the growth of the pterygium and determine if it is causing problems with vision.
In some cases, when other treatments have failed, vision is at risk or for cosmetic reasons, referral to an ophthalmologist may be recommended for surgical removal of the pterygium. Unfortunately, there is a risk of the pterygium growing back after surgery. Certain medications and medical procedures could help prevent the recurrence of a pterygium following surgery. To minimise the risk, one should protect the eyes from sun, dust and other irritants.
To help prevent the development of pterygium and pinguecula or to slow the growth, avoid or at least reduce exposure of the eyes to environmental factors such as wind, dust, pollen and smoke as well as to harmful ultraviolet light.
Wear sunglasses, even on overcast days and while travelling in the car. Wraparound styles provide the best shield against UV light, dust, and wind by offering protection from every angle.
Use artificial tears to keep the eyes moist in dry climates and to help alleviate irritation. Schedule regular eye examinations to check for pterygia and other eye conditions.
This newsletter article is authored by EyeMark.
The views and opinions expressed herein are not necessarily those of the optometrist.