Medical and Surgical Management
Pterygia and Pingecula
What is Pterygium?
A pterygium is a fleshy growth of tissue, which usually extends from the nasal side (inside) of the white part of the eye, onto the cornea (the clear window at the front of the eye).
Pterygia usually grow very slowly towards the visual axis. If they are large enough, they can cause a permanent reduction in vision.
A pingeculum is a benign growth that looks like a yellowish nodule on the interpalpebral conjunctiva, usually seen near the temporal or nasal limbus and NOT encroaching onto the cornea.
What are the causes of Pterygium?
Exposure to sunlight is the most common cause of pterygia and as a result they are very common in Australia. People at most risk are those who spend a lot of time outdoors, such as farmers, surfers and keen golfers.
What are the symptoms of pterygia?
In most cases, pterygia cause chronic dryness and discomfort. They also frequently become red and inflamed.
They can affect the sight by causing astigmatism, or, if they are large enough, by blocking the light from entering the eye.
The best way to make your eye comfortable is to use plenty of lubricants. It is also important to protect your eyes with sunglasses.
Occasionally prescription eye drops may be needed if the eye is very inflammed, although this is not recommended for long-term treatment.
What is the treatment for pterygia?
Whilst eye drops may reduce the symptoms, the only curative therapy is surgery. Surgery is usually performed as day surgery under local anaesthetic.
During the surgery, the pterygium is removed. In order to reduce the risk of the pterygium growing back, a small conjunctival graft is taken from under the upper eyelid is inserted into the bed of the pterygium. The conjunctival graft can be sutured into place, or glued. Most patients prefer the glue as it provides a better cosmetic outcome and is significantly more comfortable compared to sutures.
After the procedure is completed, an eye patch will be applied for your comfort.
After the operation you will need to regularly use anti-inflammatory eye drops for at least one month.
What are the risks?
Generally speaking, pterygium surgery is safe, however, as with any operation, there are some risks.
The most common complication with pterygium surgery is regrowth. The risk of this occurring is less than 1 in 40 (2.5%). If it does occur, usually it is mild, and no further surgery is required. In rare cases a recurrent pterygium may need to be removed again.
There is also a risk that the conjunctival graft may dislodge (therefore don’t rub your eye after the surgery) and a risk of infection.
As mentioned above, after the pterygium is removed, the shape to the cornea may change. Since the focussing of the eye is dependent on the shape of the cornea, it is common to notice some transient blurred vision for several weeks following the surgery. Occasionally this may require you change your glasses if the blurred vision persists.
It is extremely rare for pemanent loss of vision to occur following pterygium surgery.