A pterygium, pronounced with a silent P, is a fibrous, fleshy growth on the surface of the clear cornea, usually beginning on the inner aspect of the eye. A degenerative change in normally existing structures, it occurs most frequently in patients who are exposed to lots of sun, wind, dust, or harsh climates. Most commonly seen in the tropics and in areas of wide temperature swings, pterygia are also seen in temperate climates among individuals who work or spend much of their time outdoors. They are three times more common in men than women.

What causes a pterygium?

Dryness and exposure to ultraviolet light seem to be important factors in their development. They tend to be slowly progressive, but in many patients pterygia stabilize and don’t seem to cause problems.

Sometimes patients mistake pterygia for cataracts, but cataracts form behind the colored part of the eye in the lens and are not easily seen with the naked eye as are pterygia.

What are the symptoms?

Symptoms are not severe, but they may include blurred vision, irritation, or complaints of dry eyes (itching, a burning feeling, or a scratchy sensation). During times of growth, they appear swollen and red.

What are treatment options?

The best form of therapy is prevention, such as wearing hats and dark glasses or UV blocking glasses in bright sunshine. No treatment is necessary if the pterygium is not causing any noticeable problems or symptoms. Drops may aid the dryness and the intermittent inflammation associated with this condition.

If clear vision is threatened by the presence of a pterygium, surgical excision is indicated. Other indications for surgery are increasing astigmatism or the desire for removal for cosmetic reasons.

Surgical removal is complicated by two factors:

  • Pterygia often recurs, sometimes quite rapidly after removal. Certain forms of radiation therapy and drops are available to reduce this risk. Nevertheless, recurrence is a difficult problem especially in high risk climate areas.
  • Despite adequate excision, symptoms of dryness and irritation may persist.