Pterygium
En Español (Spanish Version)

Definition
A pterygium is an abnormal, noncancerous growth of the conjunctiva. The conjunctiva is a thin membrane lining the inside of the eyelid and part of the eyeball. It is located between the sclera, or the "white of the eye" which surrounds the eyeball, and the cornea, the dome-shaped window covering the front of the eye which is responsible for the refraction of light. If a pterygium continues to grow, it may spread onto the cornea.

The Conjunctiva

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Causes
Excessive growth of the conjunctiva leads to a pterygium. The exact cause of pterygium is unknown.

Risk Factors
A risk factor is something that increases the chances of developing a disease or a condition.

Risk factors for pterygium include:
  • Excessive exposure to environmental conditions (sunlight, dust, dirt, heat, dryness, wind, smoke) due to
    • Occupations
    • Outdoor hobbies
  • Work in occupations with excessive exposure to solvents or chemicals
  • Family members with pterygium
  • Sex: male
  • Increasing age

Symptoms
The symptoms of pterygia vary from person-to-person. It appears as a fleshy spot—whitish in color and containing blood vessels—extending onto the surface of the eye. In some people, pterygia remain small and do not affect vision. These pterygia are noticed only because of their abnormal cosmetic appearance. In other people, pterygia grow quickly and large enough to eventually distort the corneal surface and cause severely blurred vision. Pterygia do not cause pain.

Symptoms may include:
  • Redness
  • Dryness
  • Irritation
  • Tearing
  • Sensation of something in the eye
  • Blurred vision

If you experience any of these symptoms do not assume it is due to pterygium. These symptoms may be caused by other eye conditions. If you experience any one of them, see your eye doctor.

Diagnosis
Your eye doctor will ask about symptoms and medical history, and perform a complete eye examination. Tests may include the following:
  • Visual acuity—a test to measure your ability to see and read the smallest letters on an eye chart mounted 14 to 20 feet away
  • Slit lamp examination—a bright light with magnification used to view the eye
  • Corneal topography—a computerized test that maps changes to the curvature of the cornea
  • Photo documentation—photography to record the degree of growth of a pterygium

Treatment
The main goals of treating a pterygium are to:
  • Prevent progression, inflammation, and infection
  • Aid in the healing process, if surgery is performed

Treatment options include:

Observation
  • Periodic eye examination, usually when the pterygium causes no or minimal symptoms
  • If symptoms increase, additional treatments may include:
    • Medications
      • prescription topical antibiotics to prevent infection
      • topical corticosteroids to reduce inflammation
      • ocular lubricants, such as artificial tears
    • Radiation therapy to stop pterygium cells from reforming

Surgery
If vision becomes severely blurred, the pterygium may need to be surgically removed. This is commonly done on an outpatient basis. On occasion, a pterygium can return. Steps may be taken during the operation to prevent this from happening.

In rare cases, a pterygium causes serious scarring of the cornea. If this happens, a corneal transplant may be needed. Once the pterygium has been surgically removed, the medicine Mitomycin C may be used to aid in healing and prevent recurrence.

Prevention
To help reduce your chances of developing a pterygium, take the following steps:
  • Wear dark glasses with UV protection to shield the eyes from sun, dust, and wind
  • Avoid harsh environmental factors to slow the growth or regrowth of pterygium




RESOURCES:
American Academy of Ophthalmology


CANADIAN RESOURCES:
Canadian Ophthalmological Society


References:
Coday M. Pterygium. Digital Journal of Ophthalmology website. Available at: http://www.djo.harvard.edu/site.php?url=/patients/pi/426. Accessed July 21, 2009.

Jurgenliemk-Schulz IM, Hartman LJ, Roesink JM, et al. Prevention of pterygium recurrence by postoperative single-dose beta-irradiation: a prostpective randomized clinical double-blind trial. Int J Radiat Oncol Biol Phys .2004; 59:1138-1147.

Kellogg Eye Institute. Pterygium. Kellogg Eye Institute, University of Michigan website. Available at: http://kellogg.umich.edu/patientcare/conditions/pterygium.html. Accessed August 12, 2005.

Sowka JW, Gurwood AS, Kabat AG. Handbook of Ocular Dsease Management. New York, NY: Jobson Publishing Co; 2001.

Washington University Physicians. Pterygium. Washington University Physicians website. Available at: http://wuphysicians.wustl.edu/page.aspx?pageID=516. Accessed November 11, 2010.

Last Reviewed June 2013



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