Middle aged man with pterygium in left eye

7 Things You Should Know About Pterygia

Pterygium may not be a word you’re familiar with, but if you live anywhere with a lot of sun and surf (such as California), chances are that you’ve seen one (or even have one yourself. Maybe even two.) This fleshy growth on the front surface of the eye is a very common condition, albeit an unsightly one. Pterygia (the plural of pterygium) appear like a triangular whitish-yellowish overgrowth from the whites of the eye over the transparent cornea. In the very early stages of a pterygium, you may not even realize you have one developing. If that last statement has you peering closely into a mirror to find that you indeed have the beginnings of a pterygium, stay calm and keep reading.

True Facts About Pterygia

All the facts you read in this blog about pterygia are true. However, this blog cannot tell you whether that thing on your eye is actually a pterygium or something else, so it’s always best to get properly examined by an optometrist or ophthalmologist if you notice any new growths.

1. A pterygium is not cancer.

A pterygium is not malignant or cancerous, and does not spread to other structures of the eye other than the cornea. If abnormal cells do start to invade and damage surrounding tissues, then it’s not a pterygium – never was and never will be.

Interestingly, pterygia do share some similarities to cancerous growths, such as being related to ultraviolet radiation exposure. There have been some reports of pterygia demonstrating some molecular changes that could be considered as precancerous, however, this depends on the classification system used.

2. A pterygium and pinguecula are similar but not quite the same.

Pterygia and pingueculae (the plural of pinguecula) share many similarities. Both appear as a white-yellow overgrowth of tissue on the front of the eye; both are benign and noncancerous; both are related to UV exposure. Both can also cause occasional irritation, like dryness or the feeling of a particle stuck in the eye; both are otherwise painless.

The main feature that distinguishes a pterygium from a pinguecula is that a pterygium will encroach onto the cornea, the clear dome of tissue covering the colored iris. Meanwhile, pingueculae politely keep to their place on the white sclera and don’t step on any toes (or corneas).

3. Environmental conditions and genetics can contribute to developing a pterygium.

Pterygia are sometimes also referred to as “surfer’s eye”, given the predisposition of surfers to develop the condition. UV exposure is known to play a significant role in causing pterygia, and since surfers don’t tend to wear sunglasses or hats while in the surf, their eyes get the full blast of glorious sun. Other contributing factors to the development of pterygia include exposure to wind and dust, meaning those with an outdoor occupation also tend to be at greater risk of pterygia. Studies have noted that people with dry eyes and abnormal tear production may also be at a higher likelihood of developing a pterygium, possibly due to the increased vulnerability of a dry eye to environmental conditions.

There is some suggestion of a hereditary component to pterygia too, though this more complicated than having a parent with a pterygium meaning you will get one also. Specific genes have been identified as being responsible for changing the activity of certain proteins, leading to pterygium development. Another theory is that one may have a genetic predisposition to sensitivity to pterygium-inducing environmental factors.

4. There are ways you can protect your eyes from developing pterygia.

Though genetics play a role in pterygia and there’s not much you can do about that, there are still steps you can take to reduce your risk of developing a pterygium or, if you already have one, of it growing further.

Firstly, protect your eyes from UV like your sight depends on it. Not only will this reduce your risk of a pterygium, it also protects you from a whole list of other UV-related eye conditions. These include pingeculae, ocular melanoma, cataracts, and carcinomas. And wrinkles.

Secondly, if you have dry eyes, consider using artificial tears and lubricants. These non-medicated eye drops help to protect and cover the surface of the eye as well as relieve the discomfort of a dry eye surface.

5. Pterygia are associated with a higher risk of skin cancer.

Studies have noted that the presence of a pterygium can be a valuable warning sign that an individual is at a higher risk of skin melanoma or other non-melanoma skin cancers. One does not cause the other but it is thought they share the same underlying cause (UV exposure) and whatever predisposes one to a pterygium also makes one more vulnerable to skin cancer.

6. Pterygia can be easily removed with surgery but often recur.

The removal of a pterygium is fairly straightforward with a day surgery procedure. Historically, there have been various methods of cutting out these growths, including one called the bare sclera technique. This involved simply surgically peeling off the pterygium and then calling it a day, but this method is associated with a recurrence rate of up to 89%, so doctors try not to do that one anymore.

Other techniques include conjunctival autografting. This involves suturing over a piece of conjunctival tissue taken from elsewhere in the eye once the pterygium has been removed, rather than leaving the excision area exposed as in the bare sclera technique. The rate of the pterygium recurring with this technique is up to 40% but has been reported as low as 2%.

A third technique is known as amniotic membrane grafting. Similar to the conjunctival autograft technique, this method seeks to avoid leaving a naked excision site by covering it with healthy tissue. Amniotic membrane, or amnion, comes from a layer of the placenta of mammals. Sounds weird sticking a bit of that on your eye? Maybe so, but amniotic membrane grafts have great healing properties and can reduce the recurrence rates after pterygium surgery.

7. If the pterygium doesn’t bother you, you can ignore it.

Being noncancerous, if you’ve got no issues with your pterygium, it’s got no issues with you. It’s quite safe to leave a pterygium and co-exist happily; you can discuss with your optometrist or ophthalmologist what their recommendations might be in your specific situation. The main indications for pterygium surgery are if it is constantly causing irritation, if the cosmetic appearance is a concern, or if the pterygium has grown large enough to interfere with your vision.

In rare cases, your eye doctor may recommend pterygium removal even if you’re unperturbed. If the pterygium appears to be progressing rapidly, you may be advised to have it excised sooner rather than later. Occasionally, pterygium removal can leave some corneal irregularity, which can affect your vision if the disturbance is central enough. To avoid the pterygium from reaching that far and causing that risk, your eye doctor may suggest you undergo surgery.

Pterygia (and pinguleculae) the most common diagnosis for white lumps on the eye, but if you notice a new growth or bump on your eye, don’t forget that it’s still worthwhile having it examined by an eyecare professional.