Pterygium

Dr. Whitman: Welcome to Key-Whitman. I’m Dr. Whitman and today I will be joined with Dr. Haq and Dr Barke to talk about treating a Pterygium.

What is a pterygium?

A Pterygium is a common condition that often affects people who spend a lot of time out of doors. People with a pterygium have a fleshy growth of tissue on the white of the eye usually on the side closest to the nose. It is noncancerous and usually grows slowly over time. At some point it may stop growing and then start again. Over time it can progress and begin to covers the pupil of the eye which interferes with vision. A pterygium may affect one or both eyes but is not a serious condition in most patients. It can cause annoying symptoms such as a feeling of a foreign body or redness in the eye but if allowed to grow across the surface of the eye, it can have a profound effect on your vision.

What are the symptoms?

Dr. Haq: Sometimes, a pterygium only affects appearance. An enlarging pterygium, however, may cause redness and inflammation. In some cases, a pterygium can grow onto the cornea, the clear, outer layer of the eye which can distort the shape of the cornea resulting in blurring vision. Symptoms may include burning, a gritty feeling, itching, sensation of a foreign body in the eye or blurred vision. Rarely if not removed in time, the pterygium can leave a permanent scar in the vision pathway that can limit your vision.

What is the cause?

Dr. Barke: It's not clear what causes a pterygium to develop. But most doctors believe that risk factors include prolonged exposure to ultraviolet light - living in sunny climates like Texas, dry eye, and irritants such as dust and wind. Pterygium occurrence is much greater among people who live near the equator. But it also can develop in anyone who lives in a sunny climate. It's most often seen in young adults ages 20 to 40 and it appears to be more common in men than in women.

What can be done?

Dr. Haq: Call us if you have symptoms. We can diagnose the condition by examining the front part of your eye with a microscope called a slit lamp. A Pterygium usually doesn't require treatment if symptoms are mild. If a temporary worsening of the inflamed condition causes redness or irritation, it can be treated with lubricating eye drops, ointments or prescription eye medications.

If the lesion causes persistent discomfort or interferes with vision, it can be surgically removed during an outpatient procedure. We will take into account the appearance and the size of the pterygium when making a decision about surgery. Surgery has a risk of complications, such as the recurrence of a more aggressive lesion. So surgery is usually considered only if the patient has had conservative treatments fail or their eyesight is at risk.

What should I expect after surgery?

Dr. Barke: Pterygium removal surgery is a brief out-patient surgery lasting 30 to 45 minutes. We use a graft of the patients own tissue to fill the empty space when the pterygium is removed which has been shown to reduce the chances of recurrence. After surgery, patients usually need to wear an eye patch for a day or two. After a few days you can return to normal activities being careful not to rub or touch the eye and avoiding swimming for 10 days. Often, patients are told to use steroid and antibiotic eye drops post operatively. This will reduce inflammation and also prevent pterygium recurrence.

Dr. Haq: The main complication of pterygium surgery is recurrence after removal. Without a graft, the recurrence rate is nearly 50%. Pterygium removal with a graft is associated with a much decreased recurrence risk of 5%-10%. Surgical complications may also include corneal scarring and perforation. In some cases, surgical removal of pterygium can cause astigmatism.

Patients need to be carefully followed for a year because 97% of recurrences occur during the first 12 months after surgery.

Is there any way to prevent this?

Dr. Whitman: You may attempt to prevent pterygiums by wearing UV protective sunglasses every day, even on cloudy days. Choose sunglasses that block 99%-100% of both ultraviolet A (UVA) and ultraviolet B (UVB) radiation. Wraparound sunglasses provide the best protection against ultraviolet light, dust, and wind. Experts also recommend wearing a hat with a brim to protect the eyes from ultraviolet light. To keep your eyes moist in dry conditions, apply artificial tears at least four times a day.

I hope you find this information useful and we look forward to taking care of you.

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