A pterygium (pronounced teh-RIJ-ee-um) is a non-cancerous, wedge-shaped growth of fleshy tissue on the white part of the eye (conjunctiva) that extends onto the cornea. Often called "surfer's eye," it's commonly caused by prolonged exposure to UV light, wind, and dust.
While small pterygia may not cause issues, larger ones can lead to redness, irritation, blurred vision, and even astigmatism. If left untreated, it may grow large enough to obstruct vision. Pterygium affects people in sunny climates more frequently, and those who spend long hours outdoors without proper eye protection are at higher risk.
Many patients first notice it as a pinkish, raised lesion on the inner or outer corner of the eye. Though not typically dangerous, its appearance can be concerning, and symptoms often prompt patients to seek treatment.
Pterygium excision with graft is a surgical procedure to remove the abnormal tissue and replace it with healthy tissue (a graft) to prevent recurrence. Unlike simple removal, which has a high regrowth rate, grafting significantly reduces the chance of the pterygium coming back.
During the procedure, the surgeon carefully peels away the pterygium and then covers the bare area with a conjunctival autograft (taken from under the patient's eyelid) or an amniotic membrane graft (donor tissue). This helps in smoother healing and minimizes scarring.
The surgery is typically performed under local anesthesia and takes about 30–45 minutes. It’s an outpatient procedure, meaning patients can go home the same day. The use of a graft improves cosmetic outcomes and reduces discomfort post-surgery.
Not all pterygia require surgery. Many can be managed with lubricating eye drops, steroids, or UV-protective sunglasses. However, surgery becomes necessary if:
If the pterygium is growing rapidly or causing frequent discomfort, an ophthalmologist may recommend excision before it worsens. Delaying surgery in such cases can make the procedure more complex later.
Proper preparation ensures a smooth procedure and recovery. Here’s what to expect:
1. Pre-Surgical Consultation: Your eye doctor will examine the pterygium’s size and location, check for underlying conditions, and discuss anesthesia options.
2. Medication Adjustments: If you take blood thinners (like aspirin), you may need to pause them briefly before surgery to reduce bleeding risks.
3. Arrange Transportation: Since you’ll receive local anesthesia (sometimes with sedation), you shouldn’t drive yourself home.
4. Fasting (if required): If sedation is used, you might need to avoid eating for a few hours before the procedure.
5. Post-Surgery Supplies: Stock up on prescribed eye drops, cold compresses, and avoid strenuous activities for a week.
The surgery follows these key steps:
1. Anesthesia: Numbing drops and a local anesthetic injection ensure you feel no pain.
2. Pterygium Removal: The surgeon delicately separates the growth from the cornea and sclera (white of the eye).
3. Graft Placement: A thin layer of healthy conjunctiva (or amniotic membrane) is stitched or glued over the excision site.
4. Anti-Scarring Measures: Mitomycin-C (a mild chemotherapy agent) may be applied to prevent recurrence.
5. Protective Shield: A temporary eye patch or shield is placed to protect the eye.
The entire process is quick, with most patients reporting only mild pressure sensations. You’ll rest briefly before heading home.
Two primary grafts are used in pterygium surgery:
1. Conjunctival Autograft: The gold standard. A small piece of healthy conjunctiva is taken from under the upper eyelid and transplanted. It blends seamlessly and has a low rejection risk.
2. Amniotic Membrane Graft: Derived from donated placental tissue, this graft reduces inflammation and promotes healing. Ideal for high-risk cases or thin conjunctiva.
Your surgeon will choose the best option based on your eye’s condition. Both methods significantly lower recurrence rates compared to bare excision.
Recovery typically takes 2–4 weeks. Follow these guidelines:
First 48 Hours: Rest with the eye shield on. Avoid rubbing or getting water in the eye.
Medications: Use prescribed antibiotic and anti-inflammatory drops to prevent infection and swelling.
Activity Restrictions: Skip swimming, heavy lifting, and dusty environments for at least 2 weeks.
Follow-Up Visits: Your surgeon will monitor healing and remove sutures (if used) at 1–2 weeks.
Mild redness and grittiness are normal initially. Vision stabilizes as the eye heals.
While generally safe, potential risks include:
Seek immediate help if you experience severe pain, vision loss, or pus discharge.
Q: Is pterygium surgery painful?
A: No—anesthesia ensures comfort during the procedure. Mild soreness afterward is managed with OTC painkillers.
Q: How soon can I return to work?
A: Most patients resume desk jobs within 3–5 days. Outdoor jobs may require 1–2 weeks off.
Q: Will my vision improve after surgery?
A: If the pterygium caused astigmatism, vision often improves. Otherwise, it prevents further deterioration.