What is pterygium, and why does it need to be removed surgically?

Pterygium is also called “surfer’s eye” because surfers thrive in sunny and windy conditions, the same elements needed for a pterygium to grow. Pterygium is fleshy tissue filled with blood vessels that conceal the cornea and, as a result, hinder clear vision. Pterygia are most likely to grow over time. This tends to happen when you spend a lot of time in the sun or in windy and dusty atmospheres.

The early signs of pterygium include:

  • A fleshy pink growth on the eye
  • Red eyes
  • Irritated eyes leading to itchiness
  • Watery eyes

Pterygium is often removed when tissue extends the cornea and obstructs vision. The abnormal growth of tissue may even tug the cornea or alter its shape, leading to astigmatism when the cornea is not curved completely.

How do I know I have pterygium?

Your doctor can diagnose pterygium using a slit lamp. A slit lamp is a microscope that makes use of a fraction of light to examine the inside of the eye. Further diagnostic tests include a visual acuity test that entails reading numbers or letters from a chart a few metres away and a corneal topography that captures images of the corneal surface and presents the images using a 3-D map.

How is pterygium surgery performed?

Surgery to remove a pterygium is typically required when eye drops or topical ointments have failed. First, an ophthalmologist numbs the eyes using local anaesthetic and sedates you so you will not feel anything during the procedure. Then, only the pterygium is taken out, and an amniotic membrane which is biological material that makes up the inner part of the placenta is used to bandage the affected eye. For decades, this has been used as a natural dressing for various surgical procedures.

A healthy portion of conjunctiva tissue is used to conceal the area where the pterygium was removed. This is known as an autograft procedure because healthy tissue is taken from behind the top eyelid. By using an autograft, surgeons can reduce the risk of pterygium returning.

Pterygium can resurface on the white part of the eye. The many ways of removing this can be done through a blunt dissection by cutting and peeling the pterygium from the corneal surface, or surgeons can use a laser to destroy the tissue. Afterwards, a graft is used to patch up the site. The procedure lasts under fifty minutes and is painlessly carried out.



How does the graft stay in place after pterygium surgery?

Sutures or natural glue is used to hold the graft in place. However, fibrin glue is more commonly used today. This hides the presence of surgery, prevents the pterygium from returning, and does not take as much time as sutures to secure the conjunctival graft.

Does it take long for the eye to recover after pterygium surgery?

Recovery can take some time, anywhere between a few days over several weeks. Therefore, it is best to continue with regular follow-ups to ensure you are healing well after the procedure. Side effects of bleeding, graft misalignment and recurrence should be attended to immediately.

Dr Philip and Dr Precious Phatudi
are skilled ophthalmologists based in Sandton