A pterygium is a non-cancerous growth originating on the conjunctiva, the clear membrane covering the white of the eye. This fleshy tissue often appears pink or white, starting near the nose and growing toward the center of the eye. Its characteristic triangular or wing-like shape led to its common nickname, “Surfer’s Eye.” Although benign, the growth can cause significant irritation and potentially affect vision.
Pterygium is Chronic: Understanding the Duration
The most direct answer to how long a pterygium lasts is that it persists indefinitely unless surgically removed. It is a chronic condition that does not resolve spontaneously once the tissue has formed. While the growth is permanent, its presence is often marked by periods of acute inflammation, which can cause eye redness, burning, and irritation.
Many patients describe a constant sensation of having a foreign body or grit stuck in the eye. This is a direct effect of the raised tissue disrupting the natural tear film. The growth becomes medically significant when it progresses far enough to encroach upon the cornea, the clear front dome of the eye. Once this happens, the pterygium begins to interfere with vision, signaling a need for more active management.
Factors Driving Growth and Severity
The primary driver of pterygium development and growth is exposure to ultraviolet (UV) radiation, particularly from sunlight. Extended time spent outdoors, especially in high-UV environments, contributes to the chronic damage that causes the conjunctival tissue to grow abnormally. This explains why the condition is common among those who work or recreate in sunny, exposed areas.
The rate of progression can vary widely; some pterygia remain static for years while others grow rapidly. Secondary environmental factors such as wind, dust, and chronic ocular dryness also serve as irritants that promote inflammation and growth. Managing these irritations with frequent use of lubricating eye drops can help calm the surface inflammation, but this only addresses the symptoms, not the underlying tissue growth.
Managing Pterygium: When Is Intervention Needed?
Management of a pterygium falls into two categories: observation for small, non-progressive lesions or surgical intervention for advanced cases. Observation is recommended when the growth is small, causes minimal discomfort, and has not yet started to impair vision. Symptomatic relief often involves anti-inflammatory eye drops or artificial tears to reduce redness and irritation.
Indications for Surgery
The criteria for surgical excision become compelling when the growth begins to threaten visual function. A primary indication is the induction of corneal astigmatism, which occurs because the traction of the pterygium changes the shape of the cornea. Lesions extending more than 3 to 3.5 millimeters onto the cornea often cause a clinically significant degree of astigmatism, frequently exceeding one diopter, which necessitates removal. Surgery is also indicated for severe, persistent discomfort or significant cosmetic concerns.
The definitive treatment involves surgically excising the abnormal tissue from the cornea and sclera. To prevent recurrence, the exposed area is typically covered using specialized techniques, such as a conjunctival autograft. This involves transplanting a small, healthy piece of the patient’s own conjunctiva from another part of the eye to cover the surgical defect.
The Risk of Return After Removal
While surgery is the only way to permanently remove the growth, the risk of recurrence is a significant factor in the long-term prognosis. Simple surgical excision without adjunctive measures has historically been associated with high recurrence rates. Modern techniques, particularly the use of a conjunctival autograft, have substantially reduced this risk, with reported recurrence rates often falling into the single to low double digits.
Recurrence is particularly common in younger patients, specifically individuals under 50 years old. To minimize the chance of the pterygium growing back, surgeons may use anti-metabolite agents like Mitomycin C (MMC) during the procedure. This medication is applied briefly to the surgical site to inhibit the rapid cell proliferation that leads to recurrence. Long-term success after removal requires diligent post-operative care and continued protection from UV light and environmental irritants.