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by Duffek C

Pterygium

Definition

A pterygium is an abnormal, noncancerous growth of the conjunctiva. The conjunctiva is a thin membrane lining the inside of the eyelid and part of the eyeball. It is located between the sclera, or the "white of the eye" which surrounds the eyeball, and the cornea, the dome-shaped window covering the front of the eye which is responsible for the refraction of light. If a pterygium continues to grow, it may spread onto the cornea.
The Conjunctiva
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Causes

Excessive growth of the conjunctiva leads to a pterygium. The exact cause of pterygium is unknown.

Risk Factors

Pterygium is more common in men and in those of increasing age. Other factors that may increase your chance of pterygium include:
  • Excessive exposure to environmental conditions (sunlight, dust, dirt, heat, dryness, wind, smoke) due to
    • Occupations
    • Outdoor hobbies
  • Work in occupations with excessive exposure to solvents or chemicals
  • Family members with pterygium

Symptoms

The symptoms of pterygia vary from person-to-person. It appears as a fleshy spot—whitish in color and containing blood vessels—extending onto the surface of the eye. In some people, pterygia remain small and do not affect vision. These pterygia are noticed only because of their abnormal cosmetic appearance. In other people, pterygia grow quickly and large enough to eventually distort the corneal surface and cause severely blurred vision. Pterygia do not cause pain.
Pterygium may cause:
  • Redness
  • Dryness
  • Irritation
  • Tearing
  • Sensation of something in the eye
  • Blurred vision

Diagnosis

Your eye doctor will ask about symptoms and medical history. An eye exam will be done.
Tests may include the following:
  • Visual acuity—to measure your ability to see an eye chart
  • Slit lamp examination—a bright light with magnification used to view the eye
  • Corneal topography—a computerized test that maps changes to the curvature of the cornea
  • Photo documentation—photography to record the degree of growth of a pterygium

Treatment

The main goals of treating a pterygium are to:
  • Prevent progression, inflammation, and infection
  • Aid in the healing process, if surgery is performed
Treatment options include:

Observation

Your doctor will schedule periodic eye exams to monitor the pterygium. If symptoms increase, additional treatments may include:

Medications

Medications to treat pterygium may include:
  • Prescription topical antibiotics to prevent infection
  • Topical corticosteroids to reduce inflammation
  • Ocular lubricants, such as artificial tears

Surgery

If vision becomes severely blurred, the pterygium may need to be surgically removed. This is commonly done on an outpatient basis. On occasion, a pterygium can return. Steps may be taken during the operation to prevent this from happening.
In rare cases, a pterygium causes serious scarring of the cornea. If this happens, a corneal transplant may be needed. Once the pterygium has been surgically removed, medication may be used to aid in healing and prevent recurrence.

Prevention

To help reduce your chance of pterygium:
  • Wear dark glasses with UV protection to shield the eyes from sun, dust, and wind
  • Avoid harsh environmental factors to slow the growth or regrowth of pterygium

RESOURCES

American Optometric Association http://www.aoa.org

Eye Smart—American Academpy of Ophthalmology http://www.eyesmart.org

CANADIAN RESOURCES

Canadian Ophthalmological Society http://www.cos-sco.ca

Health Canada http://www.hc-sc.gc.ca

References

Coday M. Pterygium. Digital Journal of Ophthalmology website. Available at: http://www.djo.harvard.edu/site.php?url=/patients/pi/426. Accessed July 21, 2009.

Corneal disease—Pterygium and Stevens-Johnson syndrome. Washington University Physicians website. Available at: http://wuphysicians.wustl.edu/page.aspx?pageID=516. Accessed November 11, 2010.

Jurgenliemk-Schulz IM, Hartman LJ, Roesink JM, et al. Prevention of pterygium recurrence by postoperative single-dose beta-irradiation: a prostpective randomized clinical double-blind trial. Int J Radiat Oncol Biol Phys.2004; 59:1138-1147.

Kellogg Eye Institute. Pterygium. Kellogg Eye Institute, University of Michigan website. Available at: http://kellogg.umich.edu/patientcare/conditions/pterygium.html. Accessed August 12, 2005.

Sowka JW, Gurwood AS, Kabat AG. Handbook of Ocular Dsease Management. New York, NY: Jobson Publishing Co; 2001.

Revision Information

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