Removal of a Pterygium

In my last column we discussed the triangular tissue that sometimes grows to cover the eye called the pterygium. Just to summarize, here are a few key points.

1. A pterygium is an abnormal piece of flesh usually triangular in shape that grows on the eyeball and slowly extends on to the cornea of the eye. (A pterygium is not a Cataract){{more}}

2. People who spend a lot of time outdoors who are exposed to the ultraviolet light of the sun and windy conditions and those who live under extreme dry and dusty conditions are more prone to have pterygia (plural for pterygium)

3. If the pterygium is small, there may be hardly any symptoms. Larger pterygia cause an unevenness on the eyeball that feels like a foreign body when blinking, sometimes causing dryness and a sandy gritty feeling in the eye.

4. If left to grow on to the cornea too long they may cover the pupil of the eye and decrease vision and also change the shape of the cornea inducing astigmatism.

5. Surgical excision of the pterygium is usually indicated if the pterygium has crossed over at least one third of the cornea or if it interferes with your vision

It must be said that fewer than 1/3 of all pterygia have a tendency to reoccur. In such cases a different surgical approach is indicated. Most surgeons seek to divert the direction of the blood vessels in the area of the excised pterygium , sometimes using sutures in order to change direction of conjunctival tissue away from the cornea.

In cases of recurrence, it is not uncommon for surgery to be repeated. This time a conjunctival graft is preferred. Healthy conjunctival tissue is taken from another area of the eye and is used to cover the area of excised pterygium. There are different types of surgical methods, some also include the use of mitomicin, an anticancer drug that disables the cells in the area of excision reducing the rate of recurrence.

Some surgeons prefer to glue new tissue to the excised area and the cornea is usually polished to remove any residue. A local anesthetic is applied to the eye so that no pain is felt. The eye is kept open using an eyelid speculum making access to the eye easy. The surgery is usually over in less than 15 minutes. Ointment is applied and the eye is patched for a day or two.

Lubricating drops are prescribed and the patient can resume normal activity nearly immediately or within a few days. If sutures are used they are removed several days later.

Patients are advised to use glasses or sunglasses and lubricating eye drops as they help prevent recurrence by protecting the eyes from Ultraviolet light exposure, wind and dust

Enjoy your weekend.

Dr Kenneth Onu is a resident Consultant Ophthalmologist at the Beachmont Eye Institute/Eyes R Us Send questions to: Beachmont@gmail.com

Tel: 784 456-1210