Pterygium

Symptoms of Pterygium

Pterygium often presents no symptoms in its early stages. However, when symptoms do appear, they are typically mild and manageable. Common signs and symptoms include:

1. Redness in the eye. The affected eye may appear slightly red, particularly in the area where the pterygium is growing.
2. Blurred vision. As the growth progresses onto the cornea, it can cause mild blurriness, potentially affecting overall visual clarity.
3. Eye irritation. The pterygium may cause discomfort or irritation, particularly in dry or windy environments.
4. Itching in the eye. The affected eye may feel itchy, especially in response to environmental factors like dust or pollen.
5. A warm sensation in the eye. Some individuals experience a mild, persistent sensation of warmth in the eye due to the growth.
6. Feeling of a foreign object in the eye. The pterygium can give the sensation that something is in the eye, which can be uncomfortable and distracting.
7. Difficulty wearing contact lenses. Due to irritation and discomfort, those with pterygium may find it challenging to wear contact lenses, as the growth can make contact lenses uncomfortable or cause them to dislodge.

While mild symptoms may be managed with lubricating eye drops or anti-inflammatory medications, worsening symptoms may require medical evaluation to prevent progression or discomfort.

Types of Pterygium

There are two types of pterygium: progressive pterygium and atrophic pterygium. Each type has distinct characteristics, as described below.

Characteristics of Progressive Pterygium:

1. Thick and fleshy appearance. Progressive pterygium tends to look denser and more substantial than its atrophic counterpart.
2. Large, prominent blood vessels. This type is characterized by noticeable blood vessels within the growth, giving it a more vascular and inflamed appearance.
3. Cap covering the head of the growth. A transparent or semi-transparent layer often covers the head of the pterygium, further distinguishing it from other types.
4. Continues to advance toward the cornea. Progressive pterygium typically grows toward the center of the cornea, potentially affecting vision if left untreated.

Characteristics of Atrophic Pterygium:

1. Thin and covered by a membrane. Atrophic pterygium has a thinner, less noticeable appearance compared to the progressive type.
2. Few blood vessels. The growth contains only a minimal number of blood vessels, resulting in a less inflamed look.
3. No cap covering its head. Unlike progressive pterygium, atrophic pterygium lacks a cap over its head, giving it a more transparent or mild appearance.
4. Does not worsen after initial growth. Atrophic pterygium tends to stabilize and does not typically advance further once it reaches a certain point, minimizing the risk to vision.

Progressive pterygium requires closer monitoring as it may continue to grow and cause vision issues. In contrast, atrophic pterygium is generally less problematic, though both types should be evaluated regularly to prevent potential complications.

Diagnostic Procedures for Pterygium

Diagnosing pterygium involves a few straightforward procedures that help eye specialists assess the growth’s presence, progression, and impact on the eye. Here are the primary diagnostic methods used:

1. Physical eye examination. During a routine eye exam, the doctor inspects the eye for the presence of a pterygium. Using bright lighting and magnification tools, they check for a wing-shaped growth extending from the conjunctiva to the cornea, which is characteristic of pterygium.
2. Slit-lamp examination. A slit-lamp microscope provides a detailed, magnified view of the eye’s surface, allowing the doctor to examine the pterygium closely. This examination helps assess the size, thickness, and exact location of the growth, as well as any irritation or redness it may be causing.
3. Vision tests. If the pterygium is large or has started to affect the cornea, the doctor may conduct visual acuity tests to determine if the growth is impairing vision. These tests help identify any impact on sight and evaluate whether treatment, such as surgery, may be necessary.
4. Photographic documentation. In some cases, the doctor may take photographs of the pterygium to track its progression over time. This method helps monitor growth changes, allowing for early intervention if it begins to affect the cornea or vision.

These diagnostic procedures ensure a thorough evaluation of the pterygium and help guide appropriate management, whether through monitoring, non-surgical treatments, or surgical removal if needed.

Complications of Untreated Pterygium

Although pterygium is often a benign and slow-growing condition, leaving it untreated can lead to complications, especially if the growth continues to advance. Here are some of the potential complications that may arise from untreated pterygium:

1. Vision impairment. As pterygium grows onto the cornea, it can cause astigmatism or blurred vision due to the irregular curvature of the corneal surface. In severe cases, it can even cover the visual axis, leading to significant vision obstruction.
2. Chronic eye irritation and inflammation. Untreated pterygium can cause persistent discomfort, including redness, itching, and a sensation of grittiness in the eye. This constant irritation may worsen over time, especially when exposed to sunlight, wind, or dry conditions.
3. Corneal scarring. When pterygium grows extensively over the cornea, it can lead to scarring. Corneal scarring can be challenging to reverse and may permanently impair vision, even after the pterygium is removed.
4. Increased risk of recurrence after delayed treatment. Pterygium that has grown significantly is more challenging to remove surgically and has a higher chance of recurring after removal. Early intervention, when the growth is still small, often results in better outcomes and reduces the likelihood of recurrence.
5. Cosmetic concerns and social discomfort. Pterygium can be cosmetically noticeable, often appearing as a pinkish, raised growth on the white part of the eye. For some individuals, this may lead to self-consciousness or social discomfort, particularly if the growth becomes large or inflamed.

Addressing pterygium early, whether through regular monitoring or treatment, helps prevent these complications and ensures that any impact on vision or comfort is minimized. Regular eye exams and prompt management can protect eye health and prevent the condition from progressing to more severe stages.

Causes of Pterygium

Although the precise causes of pterygium are not fully understood, researchers have identified direct environmental and biological factors that appear to contribute to its development. Here are some of the primary causes associated with pterygium:

1. Ultraviolet (UV) light exposure. The most direct cause linked to pterygium is prolonged exposure to UV rays from the sun. UV light damages the conjunctival tissue on the eye’s surface, causing abnormal cell growth that can extend toward the cornea. This is particularly common in people who spend extended periods outdoors in sunny environments without eye protection.
2. Chronic eye irritation. Continuous exposure to irritants, such as sand or wind, causes inflammation and irritation of the conjunctiva, which can stimulate abnormal tissue growth. When the conjunctiva is regularly irritated, it may develop into a pterygium as the tissue thickens and advances toward the cornea.
3. Genetic predisposition. While environmental factors play a significant role, genetic factors may also contribute to pterygium formation. Studies suggest that some individuals have a hereditary susceptibility to this condition, making them more prone to developing pterygium under similar environmental exposures.

Understanding these causes can help with preventive measures, such as wearing UV-protective sunglasses and avoiding irritants, especially for those who live in high-risk areas.

Prevention of Pterygium

Pterygium can be prevented by taking steps to avoid environmental factors that contribute to its development. The primary way to do this is by wearing sunglasses specifically designed to protect against the sun’s UV rays, dust, and wind. Ideally, these sunglasses should offer UV-blocking protection, which is essential for shielding the eyes from harmful sunlight, as well as wrap-around designs that guard against dust and wind exposure.

For those who already have pterygium, avoiding certain irritants can significantly help prevent its progression. Here are the main elements to avoid:

1. Dust. Reducing exposure to dust helps minimize eye irritation, which can aggravate pterygium and cause it to grow further.
2. Wind. Wind carries particles that can irritate the eyes, so wearing protective eyewear in windy conditions can be beneficial.
3. Pollen. Avoiding environments with high pollen levels helps reduce eye irritation, especially in those prone to allergies.
4. Smoke. Smoke from pollution, fires, or other sources can irritate the eyes, making it essential to steer clear of smoky areas when possible.
5. Sunlight. Limiting direct sunlight exposure or wearing UV-protective sunglasses can reduce the risk of further UV damage to the eyes.

Avoiding these irritants can also help prevent the recurrence of pterygium if it has been successfully treated or managed.

Risk Factors for Pterygium

The following factors increase the risk of developing pterygium:

1. Sun exposure. Pterygium commonly affects people living near the equator, where sunlight, especially UV radiation, is most intense. Those who spend significant time outdoors in these regions without eye protection are at greater risk due to continuous UV exposure.
2. Living in dry, sandy, and dusty areas. Prolonged exposure to dry, sandy, and windy environments contributes to pterygium risk. The dry air and constant presence of airborne particles can irritate the eyes, making this condition more likely to develop.
3. Age. The risk of pterygium increases with age. Studies show that, in Australia, approximately 12 percent of individuals over the age of 60 have pterygium. This condition is less common in younger people but tends to develop and progress with long-term environmental exposure over time.
4. Combination of multiple factors. Pterygium often results from a combination of the above factors. For example, individuals living in tropical, sandy areas who spend a lot of time outside and have cumulative UV exposure over many years are at especially high risk.

Recognizing these risk factors can help individuals take proactive measures, such as wearing UV-protective sunglasses and shielding their eyes from harsh environmental elements, to reduce their chances of developing pterygium.

Pterygium FAQs

Pterygium, or “surfer’s eye,” is a common eye condition involving a growth on the eye’s surface, often linked to environmental exposure. Here are answers to frequently asked questions about pterygium, covering its causes, symptoms, and treatments.

1. What causes pterygium?
   Pterygium is mainly caused by prolonged exposure to ultraviolet (UV) light, along with other environmental irritants like dust and wind. These factors can damage the conjunctiva, leading to abnormal tissue growth that may extend onto the cornea.
2. Is pterygium contagious?
   No, pterygium is not contagious. It’s a non-infectious growth caused by environmental exposure and other factors, meaning it cannot be spread from person to person.
3. Can pterygium affect my vision?
   In mild cases, pterygium does not usually affect vision. However, if the growth advances far enough onto the cornea, it can cause blurred vision or visual distortion that may require medical attention.
4. How is pterygium treated?
   Treatment varies depending on the severity. Mild symptoms can often be managed with lubricating eye drops or anti-inflammatory medication, while advanced cases may require surgical removal if the growth interferes with vision or causes significant discomfort.
5. Can pterygium come back after treatment?
   Yes, pterygium can recur after surgery, especially if exposure to UV light and environmental irritants continues. Wearing UV-protective sunglasses and avoiding irritants can reduce the risk of recurrence.
6. How can I prevent pterygium?
   Preventive measures include wearing sunglasses that block UV rays, using hats for added sun protection, and limiting exposure to wind, dust, and other irritants that may irritate the eyes.
7. When should I see a doctor for pterygium?
   You should see a doctor if you notice any growth on your eye, experience discomfort, or if your vision becomes blurred. Early evaluation can help manage symptoms and prevent progression.