Pterygium is a non-cancerous growth that develops on the conjunctiva, the clear membrane covering the white part of the eye. This fleshy, triangular tissue can gradually extend onto the cornea, which is the transparent front surface of the eye. Its development is often linked to long-term exposure to ultraviolet (UV) radiation from sunlight, as well as environmental irritants like dust and wind. The condition is commonly referred to as “surfer’s eye” due to its prevalence among individuals who spend significant time outdoors. Pterygium progresses through different stages, each with distinct characteristics and potential impacts on vision and eye comfort.
Early Stage Pterygium
In its initial phase, pterygium appears as a small, triangular growth, often pinkish or reddish, located on the nasal side of the eye. This growth originates from the conjunctiva and may barely touch the edge of the cornea. During this early stage, individuals often experience minimal or no symptoms beyond the visible appearance.
Some people might notice mild irritation, a gritty sensation, or occasional dryness in the affected eye. Vision is not impacted at this point because the growth has not significantly encroached upon the central visual axis of the cornea. The growth is either stationary or progresses very slowly, remaining stable for extended periods.
Progressive Stage Pterygium
As pterygium advances, it grows larger, becoming thicker and more elevated on the eye’s surface. This progression is often accompanied by increased vascularity, making blood vessels within the growth more prominent. The expansion of the tissue onto the cornea becomes more noticeable, leading to escalating symptoms.
Individuals in this stage may experience chronic irritation, a persistent foreign body sensation, and increased redness. As the pterygium extends further onto the cornea, it can distort the corneal surface, potentially inducing astigmatism. This change in corneal shape can result in blurred vision.
Advanced Stage Pterygium
The advanced stage of pterygium is characterized by significant growth, where the fleshy tissue extends considerably onto the cornea. The growth may reach or even obscure the pupil, directly impeding light entering the eye. This extensive encroachment leads to severe symptoms and a notable impact on visual function.
Vision loss becomes pronounced due to obscuration of the visual axis by the growth itself. Patients often report severe chronic irritation, persistent dryness, and a feeling of something constantly in the eye. In rare instances, a large pterygium can restrict eye movement, compromising daily activities and visual comfort.
Managing Pterygium at Different Stages
Management strategies for pterygium are tailored to its stage of progression and the severity of symptoms. For early-stage pterygium and less symptomatic progressive cases, conservative approaches are often sufficient. These involve lubricating eye drops to alleviate dryness and irritation. Anti-inflammatory eye drops may also be prescribed for short durations to reduce redness and inflammation when symptoms flare up. Protecting the eyes from UV radiation with sunglasses and hats is recommended to help slow or prevent further growth.
Surgical intervention is considered when the pterygium reaches a more progressive stage, causing significant symptoms, vision impairment, or induced astigmatism. For advanced cases where the growth threatens or obscures the visual axis, surgery becomes a more immediate consideration to preserve or restore vision. The primary goal of surgery is to remove the abnormal tissue, alleviate symptoms, and improve visual acuity.
Several surgical techniques are employed, with common approaches including bare sclera excision and conjunctival autograft. Bare sclera involves simply removing the pterygium and allowing the underlying sclera to heal naturally. Conjunctival autograft involves transplanting a small piece of healthy conjunctival tissue from another part of the patient’s eye to cover the area where the pterygium was removed. This grafting procedure helps reduce the likelihood of recurrence. Regular monitoring and follow-up with an eye care professional are important to assess the pterygium’s status and manage concerns.