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Pterygium
Pterygium (pronounced “tur-IJ-ee-um”) is a common eye condition, especially in sunny, windy climates like Australia. It is a non‑cancerous, fleshy growth that starts on the white part of the eye and can slowly extend onto the clear front window of the eye (the cornea). While it can look worrying, in most people it can be monitored and managed safely, and surgery is available when needed.
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What is a pterygium?
A pterygium is an overgrowth of the thin, clear skin that covers the white of the eye (the conjunctiva). It usually begins at the inner corner of the eye, closest to the nose, and can grow towards the coloured part of the eye and pupil in a triangular or wing‑shaped pattern.
Key points:
- It is not a cancer and does not spread to other parts of the body.
- One or both eyes can be affected.
- It can stay small and quiet, or slowly grow over time.
Because it is strongly linked with sunlight and outdoor exposure, pterygium is sometimes called “surfer’s eye”.
What causes pterygium?
The exact cause is not fully understood, but long‑term irritation of the eye surface seems to play a major role.
Common risk factors include:
- High ultraviolet (UV) exposure from the sun, especially without sunglasses or a hat.
- Living or working in sunny, tropical or desert climates.
- Outdoor jobs such as farming, construction, fishing and lifeguarding.
- Wind, dust, smoke and dry environments that irritate the eye.
Not everyone with these risk factors will develop a pterygium, but protecting your eyes from UV, wind and dust reduces the risk and may slow growth.
Symptoms
Some people with a pterygium have no symptoms and only notice a cosmetic change. Others may experience:
- Redness on the white of the eye, especially on the side with the pterygium.
- A gritty, dry or itchy feeling, as if something is in the eye.
- Burning or mild pain.
- Watery eyes or sensitivity to wind, smoke or air‑conditioning.
- Blurred or distorted vision if the pterygium grows far enough onto the cornea or pulls on it and changes its shape.
- Difficulty or discomfort wearing contact lenses.
If the growth reaches the central cornea (over the pupil), it can interfere with vision more severely and may cause permanent scarring if left untreated.
How is pterygium diagnosed?
Diagnosis is usually straightforward and painless.
Your eye‑care professional (optometrist or ophthalmologist) will:
- Ask about your symptoms, work, hobbies and sun exposure.
- Examine the front of your eye with a slit‑lamp microscope.
- Check your vision and glasses prescription.
- Sometimes perform a scan called corneal topography to see if the pterygium is distorting the shape of your cornea.
This helps determine whether the pterygium is only a cosmetic issue or if it is starting to affect the eye’s clarity and focus.
Do all pterygia need treatment?
No. Many small, quiet pterygia can simply be monitored over time. Treatment is considered when:
- The eye is often red, irritated or uncomfortable.
- The pterygium is growing towards the central cornea.
- Vision is blurred or glasses are no longer working well because of corneal distortion.
- The appearance of the eye is very bothersome to you.
Regular check‑ups (often every 1–2 years) allow your optometrist or ophthalmologist to spot changes early.
Non‑surgical treatment
Non‑surgical treatments do not remove the pterygium but can reduce symptoms and help protect your eye.
Common measures include:
- Lubricating drops or gels – to reduce dryness, grittiness and irritation.
- Short courses of anti‑inflammatory eye drops – sometimes used when the pterygium is very inflamed; these are prescribed and monitored by an eye specialist.
- Sunglasses and hats – wrap‑around, UV‑blocking sunglasses and a wide‑brimmed hat reduce UV exposure, wind and dust.
- Environmental changes – avoiding smoke, reducing fan or air‑conditioner airflow directly on the eyes, and taking regular breaks from screens.
For mild cases, these measures may be all that is needed, along with periodic review.
Surgical treatment
Surgery is the only way to physically remove a pterygium. It is usually considered when:
- The pterygium is growing towards or over the pupil.
- It is causing significant irritation, redness or cosmetic concern.
- It is changing the shape of the cornea and affecting your glasses prescription or vision.
What happens during surgery?
Modern pterygium surgery is usually done as day surgery under local anaesthetic, often with light sedation so you are relaxed but comfortable.
In simple terms:
- The eye is numbed with drops and sometimes a small injection.
- The surgeon gently removes the pterygium tissue from the cornea and white of the eye.
- A thin piece of healthy conjunctiva (a “graft”) is taken from under the upper eyelid area and placed where the pterygium was removed.
- This graft is secured with tiny stitches, tissue glue, or both.
Using a graft greatly reduces the chance of the pterygium growing back and usually gives a better cosmetic result.
Recovery after surgery
Everyone heals at a slightly different pace, but there are some common experiences.
After surgery:
- The eye is often red, watery and gritty for several days to a few weeks.
- Vision may be blurry at first and gradually improve as the surface smooths and inflammation settles.
- Mild to moderate discomfort is common; pain tablets are usually needed only for a short time (often 1–3 days).
You will usually be prescribed:
- Antibiotic drops for about a week to lower the risk of infection.
- Anti‑inflammatory (steroid) drops for several weeks to reduce redness and lower the chance of recurrence.
- Lubricating drops to keep the eye comfortable.
Most people can return to light duties or office work within several days, but this depends on your job and your surgeon’s advice. You will be asked to avoid rubbing the eye, swimming, and dusty or dirty environments during early healing.
Risks and possible complications
Pterygium surgery is common and generally safe, but all surgery carries some risks.
Possible issues include:
- Recurrence (the pterygium growing back), sometimes thicker or more aggressive – this risk is lower when a conjunctival graft is used and when you protect your eyes from UV.
- Infection or delayed healing.
- Scarring or persistent redness.
- Changes to the cornea that may affect vision and require glasses or contact lens adjustment.
Your surgeon will explain how these risks relate to you personally and what is done to minimise them.
Living with and preventing pterygium
For many people, pterygium is a long‑term but manageable condition. Good habits can help slow growth, reduce symptoms and lower the chance of recurrence after surgery.
Helpful steps:
- Wear quality, UV‑blocking wrap‑around sunglasses whenever you are outdoors.
- Wear a wide‑brimmed hat in addition to sunglasses.
- Use lubricating eye drops in dry, windy or dusty environments.
- Avoid smoking and minimise exposure to smoke and air pollution.
- Have regular eye checks to monitor the size of the pterygium and your vision.
Frequently Asked Questions
Is a pterygium cancer?
A pterygium is a benign (non‑cancerous) growth of the eye’s surface tissue and does not spread to other parts of the body. However, any new or changing growth on the eye should be checked to make sure it is not a different condition.
Can a pterygium make me go blind?
Pterygium rarely leads to severe vision loss if monitored and treated when necessary. In advanced untreated cases it can grow across the central cornea, scar it and cause permanent visual problems, which is why timely assessment is important.
Will my pterygium go away with drops?
Lubricating or anti‑inflammatory drops can ease redness and irritation but do not remove the pterygium itself. The only way to remove the growth is with surgery.
Do I have to have surgery?
Not necessarily. Many people with small, stable pterygia never need an operation and are managed with drops, sun protection and regular check‑ups. Surgery is recommended when the growth affects vision, causes significant symptoms, or is cosmetically very troubling.
Is pterygium surgery painful?
During surgery, the eye is numbed with anaesthetic so you should not feel pain, though you may feel pressure or gentle movement. After surgery, discomfort is common for a few days but usually improves with pain tablets and lubricating drops.
How long will recovery take?
Most people notice improvement over the first week, with redness and irritation gradually settling over several weeks. Your surgeon will advise when you can drive, work, swim and resume sports, depending on how your eye is healing.
Can the pterygium come back after surgery?
Yes, there is always some risk of recurrence, particularly in younger people and those with high UV exposure. Using a conjunctival graft during surgery, following your drop schedule and protecting your eyes from sun and wind all help to reduce this risk.
Is pterygium the same as a cataract?
A pterygium is a surface growth on the front of the eye, while a cataract is a clouding of the natural lens inside the eye. They are different conditions and are treated in different ways.
Can I wear contact lenses if I have a pterygium?
In many cases, yes, especially if the pterygium is small. If it becomes large or raised, contact lenses may feel uncomfortable or may not fit safely, and your eye‑care professional may suggest glasses or other options.
What can I do to prevent pterygium or stop it getting worse?
The most important steps are consistent UV protection (sunglasses and hat), avoiding wind and dust where possible, and using lubricating drops if your eyes feel dry or irritated. Regular eye examinations help ensure that any changes are picked up early and managed appropriately.