Pterygium Diagnosis

Pterygium Diagnosis

A pterygium (pronounced "tehr-RIDGE-ium") is a growth of scar tissue and blood vessels on the surface of the eye, known as the cornea. Normally, the outer surface of the eye is clear and smooth. However, when damaged by overexposure to UV light, the growth can extend across the cornea, causing foreign body sensation, irritation, redness, and eventually, visual disturbances. Left unchecked, it may eventually cause loss of vision.

No special tests are necessary but an examination is conducted under a high-powered microscope known as a slit lamp. If your pterygium is not causing visual disturbances or discomfort, you may not require medical treatment. Instead, your pterygium will be monitored for any changes and you'll be instructed on ways to prevent further sun damage by using hats and/or sunglasses.

What causes Pterygium

The primary cause of pterygium is cumulative UV radiation, typically from sun exposure. Dry, windy, and dusty conditions can also contribute to its growth. Ptergyium are often seen in those who work outside, like landscapers and construction workers. Like skin made wrinkled and leathery by sun damage, the conjunctiva responds to UV damage by becoming rough, thick, and filled with blood vessels. The thickened and uneven surface causes irritation and ultimately, trouble seeing. Left untreated, pterygium can rob you of your sight.

Prevention of Pterygium

The primary cause of pterygium, a growth of scar tissue and blood vessels on the surface of the eye, is cumulative UV radiation, typically from sun exposure. Dry, windy, dusty conditions can also contribute. Like skin made winkled and leathery by sun damage, the conjunctiva responds to UV damage by becoming rough and thick. The thickened and uneven surface causes irritation and ultimately, impaired sight. Left untreated, pterygium can rob you of your vision.

Because UV damage is the culprit behind most cases of pterygium, the best way to prevent the condition is to adequately protect your eyes from sun damage. Wide-brimmed hats and visors can help shade the eyes but sunglasses are even more crucial.

Many people mistakenly think that the higher the price tag or darker the lens, the more protection a pair of sunglasses provides. This isn't the case! In fact, neither price nor lens color guarantees adequate UV protection. Before you buy a pair of sunglasses, make sure the label indicates that they offer "100% UV Protection" or "UV 400". Oversized and wrap styles provide better protection than smaller frames.

Make sure you wear your sunglasses at all times - even in the winter and even in the shade. UV rays can bounce off of surfaces so even if you're not directly in the sun, your eyes can still be damaged. Water, snow, and sand all reflect UV rays so no matter what your environment or climate, it's important to wear your sunglasses or UV-proof goggles. If you are on the water, make sure to wear polarized sunglasses.

Treatment of Pterygium

Not all pterygia need to be removed. If yours isn't threatening your sight or causing you significant comfort, medication alone may be sufficient. Lubricating eye drops, ointments, and possibly a non-steroidal or even a mild steroid eye drop may be prescribed to reduce inflammation associated with a pterygium. If medication doesn't provide sufficient relief, and your pterygium has become large enough to cause trouble, or you'd like it removed for cosmetic reasons, surgery can be helpful.

Pterygium removal surgery eliminates the abnormal tissue from the cornea and sclera (white of the eye). The older surgical techniques left a hole in the conjunctiva (the surface of the eye) where the pterygium was removed. Unfortunately, this led to a high rate of regrowth.

A newer technique fills the gap left by the removal of the pterygium with a graft of tissue removed from under the eyelid. This graft is then sutured in place. A downside of this approach is that the stitches can cause discomfort while the eye heals. This healing period can last for weeks.

The latest advance in ptergyium removal surgery does away with the stitches altogether. The "no-stitch" autograft surgery (the tissue is an "autograft" because you donate it to yourself) uses a special kind of surgical glue made of clotting proteins found in human blood. There's little discomfort, the rate or recurrence is low, and patients are usually back to work within two days of surgery.

For individuals who have had ptergyia removed before or have aggressive ptergyia, medication can be used at the time of the surgery to prevent cells from regrowing. This medication, along with a graft of amniotic membrane, may further reduce recurrence rates of aggressive pterygia. Additionally, amniotic membrane grafts may help minimize pain, reduce inflammation, and improve the cosmetic outcome.

Pterygium Removal Surgery: What to Expect

Pterygium removal surgery eliminates the abnormal tissue from the cornea and sclera (white of the eye). The older, standard surgical technique left a bare hole in the conjunctiva (the surface of the eye) where the pterygium was removed. Unfortunately, this led to a high rate of pterygium regrowth.

A newer technique fills the gap in the conjunctiva left by the removal of the pterygium with a graft of tissue removed from under the eyelid. This graft is then stitched in place. A downside of this approach is that the stitches can cause discomfort while the eye heals. This healing period can last for weeks.

The latest advance in ptergyium removal surgery does away with the stitches altogether. The "no-stitch" autograft surgery (the tissue is an "autograft" because you donate it to yourself) uses a special kind of surgical glue made of clotting proteins found in human blood. There's little discomfort, the rate or recurrence is low, and patients are usually back to work within two days of surgery.

Advances have also been made in the treatment of recurrent, aggressive ptergyia. This adjuvant medical therapy reduces the growth of the abnormal cells. Additionally, if a lot of scar tissue prevents normal tissue even under the eyelid (the site where the graft is typically harvested), amniotic membrane grafts can be used instead of your own tissue. These techniques allow for successful removal and a reduction of recurrence rates in almost everyone!

The Procedure

The surgery is a very quick procedure lasting less than half an hour. You'll be lightly sedated to ensure that you're relaxed and comfortable. Your eye will be completely numbed and although you'll be aware of your surroundings, you won't be able to see.

The surgery consists of removing the pterygium and replacing it with a graft of tissue, which is glued into place. There are no sutures and the procedure is completely painless. Because of the medications you've received, you won't be able to drive yourself home. You might be slightly groggy from the sedation but you will be given some medications for discomfort, should you have any.

Recovery

Your eye will heal rapidly. You'll be able to return to work in about two days. After the first week, the adhesive used to secure your graft is no longer necessary and it will dissolve. Over the next two to four weeks, your eye will gradually return to a normal appearance with little or no traces of redness or irritation.