A pterygium (pronounced te-ri-gi-um, plural: pterygia) is fleshy tissue that grows in a triangular shape over the cornea. It most commonly occurs on the inner corner of the eye but can also appear on the outer corner, and it may grow large enough to interfere with vision.
What is Pterygium?
A pterygium (pronounced te-ri-gi-um, plural: pterygia) is fleshy whitish pink or creamy-coloured tissue that grows in a triangular wedge shape over the cornea. It most commonly occurs on the inner corner of the eye but can also appear on the outer corner, and it may grow large enough to interfere with vision and cause eye discomfort. Pterygia can often occur in both eyes.
About one in every 100 Australians develops a pterygium.
People can sometimes confuse pterygia with cataracts because, if left untreated, a pterygium may grow completely across the cornea impacting vision. A pterygium grows on the surface of the eye, so can be noticed by others when they look at you. Cataract is a clouding of the lens inside the eye and cannot be seen easily with the naked eye. While you can have surgery to remove a pterygium, there are no iron-clad guarantees that the condition will not reoccur.
Pterygium can also be confused with pinguecula. Although both are abnormal growths that affect the conjunctiva (the white parts of the front of your eye), the difference is that pinguecula cannot grow across the cornea, and therefore usually doesn’t affect your vision.
Causes of Pterygium
Pterygium is often referred to as ‘surfers’ eye’ because ultraviolet radiation – the type created by the sun – appears to be the main cause for its development and growth. Although anyone can develop a pterygium, they are more common in hotter climates like the northern parts of Australia and among people who spend a lot of time outdoors such as surfers, farmers and sailors. The risk is increased by not wearing sunglasses or a wide-brim hat.
The risk also increases with age and is more common in males. Estimates suggest that about 12 per cent of Australian men over the age of 60 have the condition.
Pterygium removal is possible via surgery but this does not guarantee that it will not grow back in the future.
Symptoms of Pterygium
During the early stages of pterygium development, the main concern is likely cosmetic because there is no effect on vision but it changes the eye’s appearance. The condition can look unsightly and gradually it will impede vision as the tissue growth stretches and distorts the cornea or begins to block light from entering the eye.
Pterygium can be painless at the early stage, but some people do experience mild discomfort. You might also suffer from some eye irritation or burning and the whites of your eyes might look bloodshot or pink due to fine blood vessels becoming more visible and inflamed. .
And while pterygia themselves are not cancerous, new findings published by Australian researchers suggest that people who have a pterygium are nearly 25% more likely to develop malignant melanoma – a fatal form of skin cancer.
If you have noticed any area of tissue on or around your eye or eyes that changes rapidly, we urge you to make an appointment to visit your optometrist as soon as possible.
Pterygium can be painless at its early stages but it can distort vision and cause discomfort if tissue starts growing further into the cornea.
Detecting the condition
While your pterygium might appear obvious due to the growth of tissues on your eyeball, it does need a more thorough diagnosis to determine if it is this condition, a pinguecula or something else. This should be done by an optometrist who will use a slit lamp to magnify and light your eye so that they can see it in much closer detail. Your optometrist will also perform some additional tests such as a visual acuity test (reading letters on an eye chart), corneal topography (to map the curvature of your cornea) and photo documentation (to track the growth rate of your pterygium.
Treating or removing pterygia
In cases where the pterygium is not actively growing onto the cornea, protecting the eyes from ultraviolet light will often stabilise its growth. Sometimes, pterygia become red and irritated. When this occurs, eye drops or ointments may soothe the inflammation. Your optometrist can suggest an appropriate product to use.
If a pterygium begins to grow onto the cornea and threatens to distort vision, surgical removal is required. This is normally performed at a day surgery and takes just under an hour to perform. The eye will be anaesthetised and once the pterygium is removed, the raw wound will be stitched which will dissolve over time. Your eye will be irritated for up to a week afterwards and you may also suffer from dry eye and be required to use drops for up to a month post-surgery.
Pterygia may reoccur after surgery.
If you are considering having your pterygium removed, talk to your optometrist first about the procedure and recovery and they will also recommend you to an ophthalmologist (eye surgeon) for surgery.
Wearing close-fitting sunglasses with a wide arm or a wrap-around style, along with a broad-brimmed hat is the best way to protect your eyes against UV radiation. UV radiation can also cause cataracts and other eye diseases, as well as skin cancers around your eyes, so reducing exposure is wise. It’s important to remember that UV radiation can also be reflected – from 5 per cent off grass to 25 per cent for concrete and sand and 30 per cent for sea to 90 per cent for snow.
A few tips and things to remember are:
- It’s important to wear sunglasses all year round. Don’t be fooled by clouds or the fact that you’re in the shade: a significant amount of UV penetrates cloud cover and is reflected off surfaces such as the ground, sand, water or snow.
- Optometry Australia recommends wearing sunglasses around 8 to 10am and 2 to 4pm which it says are actually the most important times to be wearing them.
- When purchasing sunglasses, remember to check the sun protection factor on the swing tag. Look for sunglasses that meet Australian Standards categories 2, 3 or 4. Your optometrist can help ensure your sunglasses fit well and are comfortable to wear. Remember that a high retail price doesn’t always mean better protection.
Commonly asked questions
What causes Pterygia?
The main cause of pterygia is exposure to ultraviolet radiation. Environmental conditions experienced in hot and dry climates may exacerbate the problem. Although anyone can develop a pterygium, they are more common in the northern parts of Australia and among people such as farmers and surfers who spend a lot of time outdoors.
Is Pterygium dangerous to my health?
Pterygia can be irritating to the eye, and cause your eye to look red, but they are not dangerous. A pterygium is a benign non-cancerous growth. They are formed by a fleshy tissue that grows in a triangular shape over the cornea. Although a ptergium is not dangerous, it should be checked regularly by your optometrist to make sure it is not something more serious.
I spend a lot of time outdoors; will I get a Pterygium?
Spending time outdoors without UV quality sunglasses and/or a hat, does increase your risk but it does not automatically mean that you will develop the condition.
Will I lose my eyesight if I have a Pterygium?
A pterygium can scar your cornea which will then need to be treated because it can cause vision loss. More commonly, your eyesight will only be affected if the pterygium starts growing over your cornea. How far the tissue has progressed across the cornea will determine the level of vision loss.
I have very red eyes, does this mean I have a Pterygium?
Red, veined eyes can be a sign of pterygium, or a number of other eye conditions. If you have red eyes, or an area of tissue on or around your eyes that changes rapidly, we encourage you to make an appointment to see an optometrist immediately for a comprehensive eye examination for diagnosis and treatment.
Can Pterygium be cured?
You may need to go onto a course of prescription eye drops or ointment for minor pterygium while for more severe cases, pterygia can be surgically removed by an eye surgeon. Your optometrist will advise the best treatment regime for your condition.
If I have my Pterygium surgically removed, does this mean I will never get the condition again?
There is no guarantee that you won’t get the condition again, even in the eye in which you had your pterygium removed.
Published date: 27 July 2016 Reviewed date: 25 March 2020
Author: Luke Arundel, BAppSci (OPtom) Hons, FIACLE, FCCLSA, FBLSA, FBCLS, AdjAssProf University of Missouri St Louis, GCOT, CASA CO
Bio: Luke Arundel is Chief Clinical Officer of Optometry Australia. He graduated with Honours in Optometry from Queensland University of Technology in 1998 and has worked extensively in Australia and Ireland. He currently holds fellowships with the BCLA, CCLSA and IACLE and became an Adj.Ass Prof. of the University of Missouri, St Louis, USA in 2008. His professional interests include keratoconus, post-graft and scleral lens fitting, dry eye, ortho-k and paediatric contact lenses. He has worked in specialty contact lens practices in Brisbane and Melbourne and in the contact lens manufacturing field along with time in the public health and education sectors. Luke’s role at Optometry Australia sees him provide professional services assistance to members in audits, investigations and medico-legal matters along with leading development of resources and special projects.
Disclaimer: No information provided on the Good vision for life website is intended to constitute or substitute advice from visiting an optometrist. Many factors unknown to us may affect the applicability of any information on this website. You should seek appropriate personalised advice from a qualified optometrist about any eye health and vision conditions.