Definition 

Pterygium is an eye condition characterized by the growth of pink tissue or membrane on the sclera (white part of the eye). This tissue may extend towards the cornea, potentially impairing vision. Usually, the membrane forms from the edge of the eye towards the center of the eyeball. Pterygium can occur in one or both eyes, with the latter condition termed bilateral pterygium. It is commonly seen in individuals who spend considerable time outdoors, exposed to sunlight, dust, or wind.

Although pterygium is generally not serious, the tissue growth can cause various uncomfortable symptoms, such as a sensation of a foreign body in the eye, redness, and irritation.

Causes

The exact cause of pterygium remains unknown. However, frequent exposure to ultraviolet (UV) rays is a significant risk factor. Pterygium is more prevalent in individuals living in tropical climates who engage in extensive outdoor activities, making their eyes more susceptible to UV light, dust, and wind.

Risk Factor

The primary risk factor for pterygium is engaging in extensive outdoor activities, which expose you to ultraviolet light, wind, and dust. Additional risk factors include viral infections, genetic predisposition, and immune factors. Individuals living in tropical climates, such as Indonesia, face a higher risk of developing pterygium. Gender also influences its incidence, with men being more frequently affected than women, likely due to their greater outdoor work exposure and subsequent susceptibility to ultraviolet exposure.

Symptoms

General symptoms of pterygium include:

• Eye redness
• Blurred vision
• Eye discomfort, described as hot or itchy
• The pterygium may impede vision if it develops and spreads to the cornea, the transparent membrane of the eye
• Sensation of a foreign object in the eye
• Dry eyes

Diagnosis

Pterygium is diagnosed by a doctor through a visual acuity examination to distinguish it from pinguecula (yellowish-white bumps on the eye). Additionally, a slit lamp examination is used to clearly observe the pterygium, which appears as a pink membrane covering the sclera. Further diagnostic procedures may include:

• Corneal topography to measure changes in the curvature of the cornea.
• Photo documentation to monitor the growth of the pterygium.

Management

Mild pterygium typically does not require treatment. However, if symptoms persist and cause visual disturbances or eye redness, a doctor may prescribe eye drops or ointments to prevent dryness and reduce redness. Steroid-containing eye drops may be recommended to alleviate itching, pain, redness, and swelling of the eye.

Surgical intervention is considered if medication fails to reduce symptoms or if the pterygium significantly affects vision and causes astigmatism or cylindrical eyes. If you would like to undergo pterygium surgery for aesthetic or cosmetic reasons, you can also consult with your ophthalmologist.

One surgical method involves using conjunctival tissue (a thin layer on the eye to protect the sclera) from the patient’s eye to replace the excised pterygium tissue. The excised tissue is replaced with new tissue, which is then sutured into the affected area. Another surgical technique uses mitomycin-C to prevent scar tissue formation.

Complications

Pterygium that develops into the cornea may result in complications such as corneal damage. If you do not get immediate treatment, you risk developing astigmatism and losing your vision.

Complications might potentially occur after pterygium surgery. In certain conditions, a pterygium might recur following surgery. After surgery, your eyes may feel dry and irritable.

Prevention

Preventing pterygium involves minimizing exposure to risk factors. Use sunglasses or hats to shield the eyes from sunlight, dust, and wind. Specialized glasses can protect against ultraviolet (UV) rays. If pterygium is already present, avoid exposure to these elements to slow its progression, such as: 

• Wind
• Dust
• Pollution
• Cigarette smoke
• Sunlight

When to See a Doctor?

You should get examined immediately when symptoms appear to prevent the pterygium from growing further. Symptoms that may appear include dry eyes or eye redness, teary eyes, eye itchiness, and a lump in the eye that feels like there is a foreign body sensation. Apart from that, immediately go to the doctor if this disorder is accompanied by blurry vision. This can indicate pterygium that has grown into the cornea or other conditions, such as a wound on the cornea or a foreign object in the eye that is attached to the cornea.

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