Pterygium (surfer's eye)

What is a pterygium?

A pterygium is a fleshy, triangular growth that develops on the conjunctiva, the clear layer over the white of the eye. Pterygia are more common on the side closest to the nose, but can occur on either side. They are associated with environmental factors, such as exposure to UV radiation (sun exposure, welding), hence the name “surfer’s eye”.

Smaller pterygia are usually harmless, but when they become larger, they can cause scarring and deterioration of vision. The growth can also change the shape of the cornea, causing vision problems due to astigmatism. Rarely, a cancer on the surface of the eye can mimic a pterygium, so it’s important to have any new growth assessed.

Many patients with pterygia have no symptoms, but some pterygia can become inflamed, irritated, or itchy. Large pterygia can block the vision, or interfere with contact lens wear.

Treatment

Treatment is considered for issues such as:

• Irritation and pain
• Recurrent inflammation
• Notable growth
• Deteriorating vision
• Unacceptable appearance
• Interference with another procedure, such as cataract surgery

Using modern micro-surgical techniques, pterygium surgery involves careful removal of the pterygium from the surface of the eye. The cornea is smoothed so that it heals with minimal scarring. The area where the pterygium was excised is replaced with a graft of healthy conjunctival tissue taken from the same eye, and is fixed to the site with fine sutures or tissue glue. This graft helps to minimise recurrence.

Recovery after pterygium surgery is relatively quick, with a return to normal visual function within a few days. There may be some surface discomfort from sutures or manipulation of the eye.

How can pterygia be prevented?

The primary approach to prevention is to reduce the exposure of the eye to ultraviolet light:

• Wear sunglasses with an EPF UV rating of 9+
• Wear a wide-brimmed hat in direct sunlight
• Wear appropriate eye protection when welding or brazing