Posted on 28 Nov 2014 18:28
A condition which can affect people whose eyes are exposed to prolonged ultra-violet light (UV from Sunlight), pterygia is a benign growth of tissue which occurs from the nasal corner, or limbus, and grows towards the pupil. These growths are wing-shaped or triangular and can also be cause by other factors, including a genetic predisposition, human papilloma virus, or immunologic alterations.
Pterygia is actually a proliferation of conjunctival tissue and its etiology is not completely clear. The growth of this tissue will arise from the corner of the eye near the nose (the limbus) and proceed over months or years towards the nasal edge of the pupil. The tissue may grow many small blood vessels which give the eye an appearance of being perpetually bloodshot, and irritation may occur. If the growth is large enough, vision may be blurred or worse.
This condition most commonly occurs in athletes such as open water swimmers, surfers, or skiers who are exposed to intense ultraviolet light, or whose eyes are chronically irritated by wind, dust, sand, or other particles. Not everyone thus exposed will develop pterygia, of course, and predisposition seems to play a role. The use of UVL-protective sunglasses should prevent the occurrence of pterygia caused by sunlight exposure. Once growth has occurred, however, sunglasses will probably not stop it from continuing, the growths do not regress on their own.
Severe Pterygium reaching the pupil
Image by José Miguel Varas, MD via wikimedia
Treatment of Pterygia
Since peterygium growths are benign, treatment will usually be symptomatic. To help check the growth of the tissue, sunglasses with good UV protection should be worn and excess sun, wind, and other irritants should be avoided when at all possible. Sometimes topical OTC decongestants, NSAID's are recommended.
Steroids may also be effective but these should ONLY be prescribed by an opthmalogist. Steroids may increase intraocular tension and and ophthalmologist will need to monitor this.
There is, however, no evidence that any of these treatment will stop the growth of pterygia or cure it. When pterygia cause problems such as astigmatism or changes in visual acuity, they may be removed surgically. Removal does not guarantee that the tissue will not regrow, so preventative measures should continue to be followed. The recurrence rate after surgery is high, however, there seems to be a decreased rate of recurrence after surgery with advancing age. Whenever possible, therefore, it is based to delay the surgical removal as long as possible. The use of special contact lenses that help protect the eye from irritants (not normal contact lenses), to prevent re-growth, has been tried with some success.
For slow-growing benign cases of pterygia, your regular physician can monitor progress. But for rapid growth, chronic untreatable irritation, restriction of eye movement, blurred vision or changes in visual acuity, and ophthalmologist should be seen. Even benign pterygia, of course, can be distressing due to cosmetic reasons, so see an ophthalmologist to discuss removal or other treatment options.