Pterygium
Definition
A pterygium is a wedge-shaped noncancerous growth of the conjunctiva, the clear membrane over the white part of the eye. Pterygium can spread to the cornea, the clear front part of the eye. A pterygium can appear on the inner or outer corner of the eye and can happen in one or both eyes.
Alternative names
Surfer’s eye; Farmer’s eye
Causes
Although the exact cause is unknown, a pterygium is associated with extended exposure to ultraviolet (UV) light from the sun.
Risk factors include:
- Aging (prevalence increases steadily with age)
- Genetics
- Living near the equator
- Outdoor occupations
- Significant exposure to sunny, dusty, sandy or windblown areas
Symptoms
While most pterygia don’t cause any symptoms, some patients experience irritation or the feeling of something in their eye.
Other symptoms include:
- Blurred vision or decreased vision if the growth extends to the central cornea
- Dry eye or a feeling of dryness
- Focal redness in the area of the pterygium
- Mild eye pain
Exams and tests
An eye care specialist normally diagnoses a pterygium through a slit lamp examination. This allows the eye doctor to magnify and examine the eye with a bright light and observe the pterygium. Sometimes an eye doctor will perform additional tests to assess vision and corneal shape.
Treatment
For pterygium, the eye doctor may recommend the following:
- If the pterygium is causing significant pain, decreased vision or is cosmetically unappealing, an ophthalmologist may offer pterygium removal surgery
- Using artificial tears (lubricating eye drops) to keep the eyes moist
- Using ointment or medicated eye drops to help alleviate irritation
- Wearing sunglasses with UV protection
Pterygium surgery
Pterygium surgery is an operating room procedure done to remove the pterygium. Depending on the severity of the pterygium, conjunctival tissue from other parts of the eye and/or amniotic membrane material is used to cover the exposed area to aid in healing. In some cases, medication is applied to reduce the chance of pterygium recurrence.
Right after surgery, the eye surgeon may choose to patch and shield the eye for protection. The surgeon will decide when the patch can be removed. Recovery usually takes about a month. The eye may be red, irritated and blurry for days to weeks. The surgeon will likely prescribe eye drops to prevent infection and reduce inflammation during this time.
Outlook (prognosis)
Most pterygia do not require intervention and only require observation for growth. The chance of growth is usually associated with the amount of UV light exposure. After pterygium surgery, there is a small chance the pterygium will grow back over months to years. If it does, surgeons may be able to perform repeat surgery.
Possible complications
A pterygium that spreads across the cornea can obscure vision or cause blurry vision by changing the shape of the cornea. It can also scar your cornea even after removal, affecting your vision. After pterygium surgery, there is a possibility of the pterygium recurring.
When to contact a medical professional
People with pterygium should be seen by an eye care professional each year. Checking it regularly will enable the condition to be treated before it affects vision.
You should call your eye doctor about a pterygium if you experience:
- A pterygium increasing in size, redness or irritation
- A pterygium over the cornea
- Blurry vision
- Your daily activities are negatively affected by the pterygium
Call your eye doctor if you’ve had a pterygium in the past and your symptoms return.
Prevention
Reduce the risk of developing pterygium by protecting your eyes from the sun and other environmental factors.
- Take regular breaks from the sun, wind and dust to give your eyes a rest.
- Use artificial tears to keep them moist and prevent dryness. If you use artificial tears more than four times a day, consider preservative-free options.
- Wear sunglasses that block 100% of UV rays, including UVA and UVB. Polarized lenses can also reduce glare and improve vision.
- Wear a wide-brimmed hat that shades your eyes and face from the sun.
References/citations
American Academy of Ophthalmology. What Is a Pinguecula and a Pterygium (Surfer’s Eye)? Updated November 2024. Accessed December 17, 2024. aao.org/eye-health/diseases/pinguecula-pterygium.
Reidy JJ. Corneal and Conjunctival Degenerations. In: Krachmer JH, Mannis MJ, Holland EJ, eds. Cornea. 3rd ed. Elsevier; 2017:870-871.
Tan DTH, Chong EW. Management of Pterygium. In: Krachmer JH, Mannis MJ, Holland EJ, eds. Cornea. 3rd ed. Elsevier; 2017:1560-1572.
Authors/reviewers
Lauren Jeang, MD
Title: Clinical Assistant Professor Cornea and External Disease, UF Department of Ophthalmology
Email: ljeang@ufl.edu
Javier Mariscal
Title: MD Candidate C/O 2027
Email: jmariscal@ufl.edu