DISEASES AND CONDITIONS

Pterygium

January 16, 2018

A pterygium (plural, pterygia) is a type of noncancerous growth on your eye. It is usually only a minor problem unless it causes visual symptoms.

The conjunctiva is the thin layer that lines the inside of your eyelids and the surface of your eye. Sometimes, part of this conjunctiva starts to grow abnormally. This growth usually starts on the white part of your eye that is closer to your nose. It can also begin on the other side. From there, the abnormal tissue can spread and cover your cornea. This is the clear window in the front part of your eye that caps the colored iris and dark pupil. The name “pterygium” is Greek for “wing.” It refers to the triangular shape of the growth.

Though a pterygium is a type of growth, it is not a type of cancer and will not spread to other parts of your body. If you have a pterygium, it might stop growing at some point, or it might continue to grow throughout your lifetime. It may grow over a period of months to years and then stop for a while. If it grows and covers your cornea, it is more likely to cause visual symptoms.

Pterygia are most common in adults in their 20s to 40s, although people of all ages can get them. They are more common in sunny climates and in people who do outdoor work. Pterygia may be slightly more common in men than in women.

Scientists aren’t sure what causes pterygia to develop. Exposure to ultraviolet light plays some role. Having certain genes may contribute to pterygia in some people as well. Infection with human papillomavirus may also play a role in the development of pterygia, but scientists are less sure about that.

Spending a lot of time in the sun may increase your risks for pterygia. Not using sunglasses may further increase your risk. If someone in your family has had a pterygium, you may be at greater risk as well.

Symptoms of pterygia are often mild. Many people don’t have any symptoms, especially if the pterygium is still small. Some symptoms can include:

  • Eye irritation
  • Eye dryness
  • Eye redness
  • Blurred vision (if the pterygium gets close to the middle of your cornea, the front window of your eye)
  • Restriction of eye movement (rare)

Some people think the cosmetic appearance of a pterygium is also a problem. Typically, a pterygium is a wedge-shaped growth, but not always. Some people notice their pterygium only after the growth has covered a significant part of their cornea and blocks the view of their iris. The pterygium might be white, pink, or red.

Your healthcare provider can diagnose a pterygium with a medical history and physical exam. This may include a detailed eye exam, especially if you have visual symptoms. Your healthcare provider might refer you to an ophthalmologist (an eye healthcare provider) for evaluation.

Usually, a medical history and exam provide enough information to diagnose your pterygium. Your eye healthcare provider will closely examine your pterygium, which can help distinguish it from other conditions. He or she must make sure that you have a pterygium and not some other condition that might need different treatment, like conjunctivitis or a cancerous growth. In some cases, your eye healthcare provider might take a small sample of the pterygium, just to make sure it isn’t a cancerous growth. However, most people won’t need this.

If your pterygium is not causing any symptoms, it may not need treatment. If symptoms develop, your eye healthcare provider might recommend the following:

  • Over-the-counter products to help with redness or irritation, like artificial tears or other eye drops, gels, or ointments
  • Prescription eye drops, gels, or ointments, if the over-the-counter products do not help
  • Surgery

Only surgery can remove your pterygium, but other treatments may help reduce symptoms. Your eye healthcare provider may be more likely to recommend surgery if:

  • Your pterygium is causing vision problems or is getting larger
  • You can’t move your eye normally
  • You have severe eye irritation that won’t go away with other treatment
  • Your eye’s appearance bothers you a lot

Unfortunately, pterygia often grow back after surgical removal. (This may be more likely if you are under age 40.) Sometimes, the pterygium that grows back causes worse symptoms than the original one. Your eye healthcare provider might find it even more difficult to remove this new pterygium. That is why eye healthcare providers don’t usually recommend removing pterygia unless they cause significant symptoms.

Your pterygia may be less likely to return if you receive other treatments in addition to your surgery. These treatments, like mitomycin C (MMC), retard growth of your cells in the area and may help prevent future growth there. A treatment called beta irradiation may also help prevent regrowth.

These additional treatment choices carry their own risks. Weigh the risks and benefits with your eye healthcare provider to see whether surgery makes sense for you.

A pterygium itself may not cause complications other than redness and eye irritation, but if it grows into your cornea, it may cause visual symptoms. You should also be aware that complications can occasionally result from treatment. For example, you might get an eye infection after surgery, or treatment with MMC might cause poor healing and lead to a corneal infection.

Not all cases of pterygia are preventable. You can decrease your risk of pterygia by reducing your sun exposure. Use sunglasses and hats when you are outside. Make sure your sunglasses block both ultraviolet A and ultraviolet B rays.

If you notice that your pterygium has started to affect your vision, plan to see your eye healthcare provider soon. Call right away for any severe symptoms, like sudden vision loss.

A pterygium is a type of noncancerous growth on your eye. It is usually only a minor problem.

  • Many people don’t have any symptoms from their pterygium. You might have symptoms like eye irritation or eye redness.
  • You might have blurred vision if your pterygium covers a large area of your cornea.
  • You might only need treatments like eye drops to reduce discomfort.
  • Some people need surgery to remove their pterygium, if it is causing significant symptoms. However, pterygia often grow back after surgery.

Tips to help you get the most from a visit to your healthcare provider:

  • Know the reason for your visit and what you want to happen.
  • Before your visit, write down questions you want answered.
  • Bring someone with you to help you ask questions and remember what your provider tells you.
  • At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.
  • Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are.
  • Ask if your condition can be treated in other ways.
  • Know why a test or procedure is recommended and what the results could mean.
  • Know what to expect if you do not take the medicine or have the test or procedure.
  • If you have a follow-up appointment, write down the date, time, and purpose for that visit.
  • Know how you can contact your provider if you have questions.

Updated:  

January 16, 2018

Sources:  

Pterygium. UpToDate

Reviewed By:  

Haupert, Christopher L., MD,Walton-Ziegler, Olivia, MS, PA-C