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What is a pterygium?

PTERYGIUM

A pterygium is a raised, triangular or wedge-shaped, benign growth of conjunctiva tissue. The conjunctiva is the mucus membrane that covers the front of your eye. It usually occurs on the side of your eye nearest your nose.


A pterygium can grow over the cornea (the transparent dome at the front of your eyeball) in a triangular fashion. As it grows it may become large enough to affect your vision.


What causes a pterygium?

A pterygium usually develops if you have been living in a sunny, hot, dry climate. This may be a response to:

  • your eye’s long-term exposure to sunlight and

  • chronic eye irritation from the dry climate and dry eye


What are the symptoms?

Symptoms include:

  • irritation

  • a feeling of something in the eye

  • intermittent redness

  • tearing (eyes watering).


As the pterygium develops it may alter the shape of the cornea, making it curve more in one direction than another and cause a condition called astigmatism.  This will affects how your eye focuses.

When the pterygium has grown towards the centre of your cornea it can obscure your vision. It can also cause permanent scarring of your cornea, resulting in loss of vision.


How is it diagnosed?

Your eye doctor will be able to see the pterygium, just by looking at your eye.  You may notice it yourself.


How can it be treated?

Treatment depends on the size and symptoms caused by the pterygium. If the pterygium is small and/or growing, you may be prescribed eye drops or ointments to relieve any redness or irritation. You may be advised to have an operation to remove the pterygium if it becomes troublesome.


For example, when:

  • it is causing constant eye irritation

  • it is causing problems with your vision

  • if you are going to have cataract surgery, then removal of the pterygium prior to cataract surgery is usually recommended to achieve the best artificial lens calculations.

  • you are unhappy with how it affects your appearance.



What are the benefits of surgery?

An operation to remove the pterygium will reduce the symptoms, such as eye irritation. It can also improve your vision and the appearance of your eye.

If you have a cataract, removing the pterygium prior to cataract surgery will allow better calculation of the artificial lens power.


What are the risks?

  • The main risk is that the pterygium will regrow. This happens in approximately 5% of people.  If this happens you may need to have it removed again.

  • There is a risk of infection, but this can be treated.

  • There is a risk of scarring to your eye. This will be explained to you before you agree to have the procedure.


Will I need an anaesthetic?

The operation is commonly performed using local anaesthetic.  It can be performed in theatre or in the eye clinic.  Local anaesthetic is a medicine which numbs a specific part of your body so it is pain free.


How can I prepare for surgery?

If you are having the surgery in clinic, you may have your meals as usual on the day of the procedure.

If you are having the surgery in a day surgery theatre, you should fast from midnight for a morning operation or fast after breakfast for an afternoon operation.

  

What does the surgery involve?

A nurse will put an anaesthetic drop into the eye which is being operated on.  Additional local anaesthetic will be injected under the conjunctiva.

The operation involves removing the conjunctival tissue over the cornea. To try and prevent the pterygium regrowing, this is often combined with the grafting of a free flap of adjacent conjunctiva over the bare area of the white of the eye.

Some surgeons also use a chemical called Mitomycin-C to help prevent the pterygium from regrowing. This is dabbed onto your eye. If your eye surgeon is planning to use Mitomycin-C, this will be explained fully to you before you sign the consent form.


The surgery usually takes about 30 to 40 minutes.


Will I feel any pain?

You may feel a little pain when you are given the anaesthetic injection, but then the operation should be pain-free.


What happens after the operation?

You cannot drive on the day after the surgery as you will have an eye patch over one of your eyes.  Therefore you will need to have someone to accompany you home after the procedure. 


At home, you will have a pad covering your eye which you will need to leave in place for 24 hours. You may remove the eye patch yourself the next day and clean around your eye with saline.

Your eye will probably feel sore or have foreign body sensation in the eye for about three to seven days after the operation.

You will be prescribed an antibiotic and steroid eye drops to use for a few weeks after surgery.


Your eye will be red for about six to 12 weeks, and then this will settle.


If you usually wear contact lenses, the eye specialist will tell you when you can start to wear them again.


Will I have any follow-up appointments?

You will come back into clinic in 3 to 4 weeks after your operation so we can check on your recover. You will then have another follow up appointment in 3-4 months.


Is there anything I need to look out for at home?

Occasionally you could get an infection in the eye. This will cause redness, pain or discharge. If this happens you should call our eye clinic or if afterhours or during public holiday please call Royal Victorian Eye and Ear Hospital on (03) 9929 8666.


When can I resume my normal activities?

You should be able to go back to work within 2-3 days, as long as you feel well enough. You can bathe or shower as normal, but you should avoid swimming for two weeks. This is because of a risk of infection.