Pterygium is one of the eye conditions that refer to a benign or non-cancerous growth of the conjunctiva, a clear, thin tissue that covers the white part of the eye (sclera). Pterygium may occur in one or both eyes.
What causes pterygium?
The cause of pterygium eye disease is not known, but can occur more often in people who spend time outdoors with frequent or excess exposure to sunlight or wind. People who spend considerable time in the sun such as farmers, fishermen and people living near the equator are more likely to have pterygium.
What are the symptoms?
The pterygium is a painless area of elevated tissue with blood vessels on the inner or outer border of the cornea. The condition can cause extreme eye discomfort including, burning, irritation, redness, tearing, foreign body sensation and astigmatism (visual defect). If the growth becomes large enough, it may begin to inhibit vision.
How is pterygium diagnosed?
Pterygium can be diagnosed by your ophthalmologist by performing a complete examination of the eye and eyelids. Treatment depends on the size and extent of the pterygium. Treatment is usually not required in case of mild pterygium. In cases in which the growth is unsightly or vision is threatened, your ophthalmologist may recommend surgical removal of the tissue.
The patient requires preoperative counselling to inform that although the surgery is successful, the symptoms may not be completely relieved, and recurrence is common and they tend to spread quickly after recurring.
How is the surgery performed?
The most common surgical technique used today involves simple excision of the pterygium combined with conjunctival auto-grafting. During the procedure, the pterygium is removed and the gap in the conjunctiva left by the removal of the pterygium is filled with a tissue transplant from the upper eyelid. The graft is held in place either with sutures or fibrin sealant or glues. This graft covers the bare area and acts as a barrier to recurrence.
An innovative and latest advance in pterygium surgery is “No-stitch Pterygium Surgery”. This procedure is similar to transplantation surgery however no stitches are used to hold the autograft in place instead the modern tissue adhesives made of clotting proteins found in human blood are used. The adhesive dissolve in a week with no residues and helps in faster recovery. No serious blood borne infections have been reported with use of adhesives and this method is considered to be safe.
In some cases, following simple excision, the topical application of the anticancer drug and beta-radiation may be used to minimise the recurrence of pterygium.
Although these therapies may slow the regrowth of pterygium, complications such as ulceration and perforation in the wall of the eye may occur.
In severe cases where the growth extends towards the centre of cornea, a laser treatment may be needed. An Excimer laser is used to smooth the surface irregularities and improve vision.
What are the tips for post-operative care?
Following surgery, you may have soreness and irritation in your eye for few days for which antibiotic and steroid combination eye drops may be recommended. You may also have redness of the eye which usually resolves over the time. Pterygium may recur after few weeks or months of surgery. You can return to your normal activities within 1 or 2 weeks after surgery. Use the eye drops and take protective measures as directed by your doctor.
What are the risks associated with surgery?
Complications such as infection and decreased vision may rarely occur following surgery.