Despite the misleading name, you don't have to be a surfer or ever see the ocean to get surfer's eye, otherwise referred to as a "pterygium". But spending a lot of time in bright sunlight — especially when you are on the water (which reflects the sun's harmful UV rays) increases your risk of developing a pterygium.
A pingueculum is a fleshy growth of the mucous membrane which starts to develop on the white part of the eye, usually in the inner corner. It is a very common condition in New Zealand. If it extends onto the cornea (the clear front surface of the eye) then it is called a pterygium. This noncancerous growth has the appearance of an elevated wedge-shaped bump on the surface of the eye, which first develops on the white of the eye (sclera). While this condition does not invade the inside of the eye or spread to any other part of the face or body, it can look red and the symptoms can become mildly irritating.
Although both a pingueculum and pterygium are benign, if left untreated a pterygium may grow further across the cornea, affecting vision and becoming more obvious. In this situation, surgical treatment may be required.
Causes and Risk Factors
Exposure to excessive amounts of ultraviolet (UV) light from the sun is thought to be the primary cause for the development of these growths. Additionally, people whose eyes are exposed to certain elements, (including pollen, sand, smoke, chemicals and wind) on a regular basis have a higher risk of developing this condition. For this reason, this condition occurs more frequently in people who live in warm climates and spend a lot of time outdoors in sunny or windy environments (for example farmers and welders).
This condition is rarely seen in children, as it usually develops in people older than 40 years of age. Pterygia occurs twice as frequently in males than females, most likely due to an increased likelihood of an outdoor work environment for men. Furthermore, being a New Zealander, it important to be aware that the risk of pterygia is higher in New Zealand compared to other regions of the world due to our depleted ozone layer causing reduced ultra-violet light filtering.
The symptoms of pingueculum and pterygium vary from person to person. While most people only notice the formation of a pterygium when looking in the mirror, others may experience mild symptoms which include:
- Eye redness and inflammation
- A gritty feeling in the eye
- A feeling that there is a foreign object in the eye
- Dryness of the eye due to reduced tear production
- Blurring or vision if the corneal surface is altered or "warped"
- Obscuring of vision if growth encroaches across the pupil.
Can You Prevent a Pterygium?
Preventative care is one of the best ways you can protect yourself from a pterygium. The most effective way to try and prevent a pterygium forming is to reduce your risk of being exposed to the elements, which includes:
- Regardless of the season, whenever you are spending time outdoors you should always wear UV protective sunglasses. Remember, not all sunglasses are made equal! When choosing a pair of sunglasses, select a pair that state "100% UVA/UVB protection" on the label.
- When you are outdoors, be sure to wear a wide brim hat which provides good coverage.
- Avoid dust and chemical pollutants. If you work in a profession where you are exposed to these irritants, be sure to wear the appropriate eyewear for protection.
- If you spend a lot of time on the water or snow, you should be extra careful to protect your eyes from UV light with the appropriate protective eyewear.
How is a Pterygium Diagnosed?
Diagnosing a pterygium is based on its appearance and is relatively straightforward. With the help of magnification and bright lighting, an eye doctor may diagnose this condition based on a physical examination using a slit lamp. Generally, no other tests are required for diagnosis.
Treatment depends on the severity of the condition. Usually, a pterygium doesn't require any treatment unless it's blocking your vision or causing severe discomfort. In this case, the treatment options may include:
To reduce the inflammation and treat the irritation and redness caused by a pterygium, your eye doctor may recommend artificial tears/moisturising eye drops and theses can be very helpful. You buy these over the counter at your pharmacy. A course of non-steroidal anti-inflammatory drops (e.g Acular, Voltaren Optha) may also be prescribed to help with inflammation. Occasionally steroid eye drops can also be used, but only under the close supervision of an ophthalmologist as they may have side effects.
Surgery is performed if a person's vision starts to become affected or if eye drops, if the pterygium is unsightly or if drops and ointments do not provide adequate relief. This surgery involves the removal of the pterygium from the sclera and cornea of the eye, which is then covered with a small graft of your own healthy conjunctiva. The graft is then secured in place with advanced natural tissue glue to aid healing and comfort.
During this procedure, you shouldn't experience any pain or major discomfort. However, it is normal for your eyes to feel scratchy for a few days after the surgery, which will shortly pass. To aid the healing process, you will need to use eye drops for about a month after the surgery.
Book an Appointment
If you are experiencing symptoms like irritation, redness, burning and blurred vision or are concerned about a possible growth of a pterygium on your eye, we recommend you book an appointment with an eye specialist.
To book an appointment with one of our expertly trained ophthalmologists at Auckland Eye, give us a call on 0800 25 53 93.