PTERYGIUM

A pterygium is a raised, wedge-shaped growth that occurs on the surface of the eye. It is thought to be related to increased exposure to ultra-violet (UV) light, as it is more common in people who have lived in sunny areas. It is not cancerous, although cancers can develop in the same area of the surface of the eye.

Pterygium starts as an area of redness and thickening on the conjunctiva, usually on the inner aspect of the white of the eye. In some cases, the pterygium may extend across onto the cornea, which is the clear front window of the eye that covers the iris. If the pterygium grows towards the middle of the cornea, it should be surgically removed.

PINGUECULUM

A pingueculum is a roughly triangular area of creamy or yellowish thickening on the surface of the eye. It is also related to UV exposure, and is very common in the Indian population.

It usually develops on the white of the eye next to the cornea, either on the inner or outer part of the eye or both. It does not generally extend across the cornea or affect the vision, although it may occasionally transform into a pterygium.

SYMPTOMS

Either lesion may be easily visible and cause cosmetic embarrassment. They often become sore, red, and gritty, especially with wind, smoke or dust. Eventually the pterygium may interfere with the vision either by distorting the cornea or by extending over the pupil.

HOW CAN A PTERYGIUM OR PINGUECULUM BE TREATED?

The comfort of a pterygium or pingueculum may be improved by using eye drops such as artificial tear drops or decongestant drops. These often help with the redness of the eye as well. Some pterygia and pinguecula which continue to cause problems such as unacceptable appearance, discomfort or effect on vision, may require surgical removal.

SURGICAL PROCEDURE

Usually after removal of the lesion has been completed, a small piece of conjunctiva, which is the thin transparent skin that covers the white of the eye, is taken from under the upper lid and placed into this site, to improve the healing and reduce the chance of the lesion growing back.

Recently tissue glue is being used in pterygium and pingueculum procedures as an alternative to sutures. Using tissue glue to attach the transplanted conjunctiva allows a slightly quicker procedure and reduces postoperative discomfort and inflammation.

The surgery is performed under topical (eye drop)/local anaesthesia. There should be no pain during the surgery, which takes approximately half an hour. Following the procedure, a prescription is given for eye ointment or eye drops and pain relief tablets.

AFTER SURGERY

For approximately 1–2 weeks following surgery, getting water, dust or dirt in the eye should be avoided.

A very large pterygium may affect the vision by causing distortion or scarring of the cornea. The vision may remain affected after removal of the pterygium and further treatment including surgery or laser to improve the corneal shape may be required.

WILL THE PTERYGIUM OR PINGUECULUM GROW BACK?

One of the main problems with the removal of a pterygium is that re-growth may occur, although this happens in fewer than 5% with newer surgical techniques. To reduce the risk of recurrence, you should try to reduce exposure to ultra-violet light following surgery by wearing sunglasses or a hat when outdoors.

The conjunctival graft is carried out mainly because it has been shown to reduce the chances of recurrence. The rate of recurrence is greater if a pterygium has been removed previously and has recurred.

Pingueculum does not usually recur although UV damage may continue to develop over a lifetime. However, occasionally the healing of the conjunctiva where the pingueculum has been removed may result in persistent irregularity, roughness or redness. This usually settles with time.

RECOMMENDATIONS

1. Protect your eyes from sun exposure

2. Protect your eyes from dust and wind

3. Use eye drops to increase comfort