Around 15 million Americans have a pterygium. Around 16 million are living with dry eye disease. Is it possible – or even probable – that there is some degree of overlap between the two conditions? July is National Dry Eye Awareness month, making now the perfect time to become aware of the impact of your pterygium on the wider health of your eye’s surface.
Dry Eye vs Pterygium
These two conditions are distinctly different entities though can be intricately linked, as you’ll find out soon. Dry eye, also termed dry eye disease or dry eye syndrome, is a complex condition involving instability of the layer of tears (the tear film) that covers the surface of the eye, and inflammation. One of the reasons dry eye disease can be such a tricky condition is that it doesn’t always come with a feeling of dry eye. You could have dry eye disease without realizing, with signs and symptoms such as:
- Burning or stinging
- Grittiness or feeling like a foreign particle is stuck in your eye
- Blurred vision
- Tired eyes
- Red eyes
Some people even experience watering, often exacerbated by the wind or in cold weather. Yep, sometimes that’s in fact a sign of dryness – as the surface of your eye dries out, it reflexively produces more tears to combat the issue.
A pterygium, on the other hand, is an abnormal growth of tissue that extends from the whites of your eye over the clear cornea. Pterygia formation is driven by UV exposure, chronic irritation from windy or dusty environments, and genetics. You can have a pterygium without symptoms, but if you look closely in the mirror, you will be able to see a triangular growth encroaching over the edge of the cornea. It is usually white or may have a pink appearance from the presence of blood vessels. Occasionally, a pterygium can cause signs or symptoms including:
- Irritation or a burning sensation
- Sensation of a foreign particle in your eye
- Blurred or distorted vision from astigmatism
- Red eye
- Dissatisfaction with the appearance of your eye
Are you noticing any similarities between dry eye disease and pterygium symptoms here?
How Pterygium and Dry Eye Are Related
Multiple studies have reported the association between dry eye disease and pterygium, though the exact relationship is akin to the chicken and egg conundrum – did the dry eye predispose to the development of the pterygium or did the pterygium trigger the dry eye?
Although the nature of the link between pterygium and dry eye disease remains unclear, we do know that the presence of a pterygium has the potential to physically disrupt the tear film and contribute to chronic inflammation of the eye’s surface, both factors that can lead to dry eye disease. On the other hand, we also know that chronic eye irritation can increase the risk of developing a pterygium.
In the quest for better understanding the association, one study even detailed how the characteristics of a pterygium impact signs of dry eye. The publication reported that the thicker the pterygium, the higher the tear osmolarity, referring to the concentration of irritating salts in the tear film. A higher tear osmolarity in dry eye disease indicates a reduced volume of water in the tear film, contributing to inflammation and all those unpleasant dry eye symptoms.
How to Manage Pterygium and Dry Eye
So, if you’re experiencing grittiness, blurred vision, red eyes, or a foreign particle sensation, do you treat the pterygium or the dry eye? Fortunately, the management of both often overlap.
Treatment for a pterygium where the main concerns are eye irritation, redness, or discomfort, often hinges on anti-inflammatory eye drops or artificial tears. Similarly, the first-line therapy for dry eye disease is artificial tears and lubricants to restore moisture to the surface of the eye and protect it from the environment. Short-term anti-inflammatory eye drops such as corticosteroids are also often used to help manage the inflammatory component of dry eye disease.
Where a pterygium is also becoming a cosmetic issue or interfering with your vision, pterygium surgery is the solution, typically with a conjunctival autograft by an experienced pterygium surgeon to minimize recurrence. Chronic eye irritation or discomfort isn’t something you should have to live with, whether due to a pterygium or from dry eye disease (or both). An exam by your eye doctor can help to determine whether conservative measures such as lubricant eye drops are sufficient or if you may benefit from pterygium removal.