What is Pterygium?

Pterygium is a non-cancerous, wing-shaped growth of tissue on the white part of the eye (sclera) that can extend onto the cornea. It usually forms on the side closest to the nose and may grow slowly over time.

Common Symptoms of Pterygium

Pterygium may start without noticeable symptoms, but as it progresses, patients may experience various discomforts, including:

Redness and eye irritation
A visible fleshy growth on the white of the eye
Foreign body sensation or gritty feeling
Dryness and increased tearing
Blurred vision (if the growth encroaches on the cornea)
Itchiness or mild burning sensation
Cosmetic concerns due to visible tissue on the eye

These symptoms may worsen with sun exposure, wind, smoke, or air pollution. Regular monitoring is essential to detect progression, especially if the pterygium begins affecting the cornea or altering vision. Artificial tears and protective eyewear can help manage mild symptoms before surgical intervention is needed.

Types of Pterygium

Though all pterygia share a similar appearance, they are generally classified based on their severity and stage of progression:

Atrophic (Inactive) Pterygium

Atrophic pterygium is a thin, flat growth on the white part of the eye, often pale with minimal blood vessels. It usually remains stable, causes no vision problems, and may not require treatment. Symptoms, if present, are mild—like dryness or irritation. Though it doesn’t grow actively, regular monitoring is recommended, especially for people frequently exposed to sun, wind, or dust. Artificial tears and sunglasses can help manage minor discomfort and prevent worsening.

Progressive (Active) Pterygium

Progressive pterygium is a thick, red, and inflamed tissue that actively grows from the conjunctiva toward the cornea. It can cause irritation, a foreign body sensation, and blurred vision if it encroaches on the visual axis. This type may worsen rapidly due to UV exposure or dry conditions. Early treatment with lubricants, anti-inflammatory drops, and lifestyle adjustments may help slow progression. In advanced cases, surgery may be necessary to prevent corneal distortion and permanent vision problems.

Recurrent Pterygium

Recurrent pterygium refers to regrowth of the tissue after surgical removal. It often appears more aggressive than the original and may grow faster with more inflammation and scarring. Symptoms typically include redness, discomfort, and visual disturbance. Risk of recurrence is higher in younger patients and in areas with high UV exposure. Close postoperative monitoring and proper surgical technique using conjunctival grafts or anti-scarring agents can reduce recurrence rates and improve long-term outcomes.

Risk Factors for Pterygium

Several environmental and lifestyle factors contribute to the development of pterygium. These include:

Chronic UV light exposure: The most significant risk, especially in tropical or sunny regions with strong sunlight.
Dust, wind, and air pollution: Irritate the ocular surface, increasing inflammation and pterygium formation.
Dry eye or chronic eye irritation: Reduced tear film makes the eye more vulnerable to external damage.
Occupational exposure: Outdoor workers, such as farmers, construction laborers, fishermen, or surfers, are particularly vulnerable.
Geographic location: Higher incidence is seen in people living closer to the equator.
Genetics: A family history of pterygium may slightly increase susceptibility.
Lack of eye protection: Individuals not wearing sunglasses or protective gear are at greater risk.

Wearing UV-blocking sunglasses, wide-brimmed hats, and using lubricating eye drops are essential preventive strategies for those at risk.

Diagnosis & Treatment of Pterygium

Diagnosis:

Pterygium is diagnosed through a comprehensive eye examination, including:

Visual acuity test to assess if vision is affected
Slit-lamp examination for detailed evaluation of the growth
Corneal topography in advanced cases to assess corneal shape and astigmatism

Treatment:

Mild Cases: Managed with lubricating eye drops or anti-inflammatory medications to relieve redness and discomfort.
Severe or Progressive Cases: Surgical removal is advised if the pterygium is growing toward the central cornea or causing visual distortion.
Surgical method: Excision with conjunctival autograft reduces recurrence risk. Sometimes, amniotic membrane grafts are used.

Recovery is usually smooth, but close follow-up is necessary to monitor healing and detect regrowth.