Pterygium

Description

Many people living in countries with a harsh dry climate, such as South Africa, develop a pterygium, which is a thin film on the white of the eyes, which grows from the nasal side towards the centre of the eye. Tiny blood vessels can usually be seen running from the base to the tip of the triangle.

Usually the lesion first appears during adolescence or early adulthood and is common amongst those who are exposed a lot to the sun and dust. It may cause redness and irritate the eye.

Symptoms of irritation such as redness, itching and scratching are common and are nothing to worry about if they occur only occasionally and are not too severe. Symptoms tend to be more troublesome in the early years when the pterygium is actively growing.

Pterygium tends to go through active, inflamed phases and quiet phases over months to years as it slowly grows onto the cornea. It typically becomes smaller and inactive after a few years of growth.

Self treatment

The pterygium itself is normally harmless and treatment is purely to relieve symptoms when they occur. A pterygium often causes a dry eye problem, and most symptoms can be relieved by using artificial tear drops.

In the case of itching, an over-the-counter antihistamine drop can be taken, taking care to use it exactly as directed. If redness is a prominent feature, a decongestant eye drop is usually effective in relieving the symptoms.

However, there is a very real danger of aggravating the problem with decongestant drops, and they should be used as infrequently as possible and only for short periods.

Lubricants and sunglasses provide relief of symptoms, but removal by surgery is the only cure. Recurrences are fairly common.

See your ophthalmologist if

• Your symptoms are not adequately relieved by the eye drops above
• Your symptoms recur frequently
• There is pus in the eye or the eyelids stick together on waking in the morning
• The pterygium covers part of the iris and grows onto the cornea and towards the pupil.
• You have any deterioration of vision
• You would like the pterygium to be removed for cosmetic reasons

Occasionally a pterygium produces unacceptable problems and needs to be removed surgically. Surgery is generally quite successful, but sometimes the pterygium grows back even more aggressively after surgery, and so surgery should not be undertaken without good reason.

Revised by Dr Clive Novis, Ophthalmologist, November 2010