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Pterygium (Surfer’s Eye) and Pinguecula

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Treatment of Pterygium

See an ophthalmologist if you have symptoms of pterygium. He or she can diagnose the condition by examining the front part of your eye with a microscope called a slit lamp.

Pterygium usually doesn't require treatment if symptoms are mild. If a temporary worsening of the inflamed condition causes redness or irritation, it can be treated with:

  • Lubricating eyedrops or ointments, such as Blink or Refresh drops
  • Occasional use of vasoconstrictor eyedrops, such as Naphcon A
  • Short course of steroid eyedrops, such as FML or Lotemax

If the lesion causes persistent discomfort or interferes with vision, it can be surgically removed during an outpatient procedure. You and your doctor may also take into account appearance and the size of the pterygium when making a decision about surgery.

Surgery has a risk of complications, one of which is the recurrence of a more aggressive lesion. So surgery is usually considered only if:

  • Conservative treatments have failed
  • The patient's eyesight is at risk
  • The patient is bothered by the cosmetic appearance or by comments from other people about the redness

The most often performed surgery is one that uses the patient's own conjunctiva (surface eye tissue) or preserved amniotic membrane (placenta) to fill the empty space created by the removal of the pterygium. In this procedure, the pterygium is removed and the conjunctiva or amniotic membrane is glued or stitched onto the affected area.

Pterygium surgery typically takes 30 to 45 minutes. After surgery, patients usually need to wear an eye patch for a day or two. But they can return to work or normal activities (avoiding swimming and eye rubbing) after a few days.

Often, patients are told to use steroid eyedrops for several weeks or months. This can reduce inflammation and the chance of pterygium recurrence.

The main complication of pterygium surgery is recurrence after removal. Without a conjunctival or amniotic graft, the recurrence rate can be as high as 50%. Pterygium removal with a conjunctival or amniotic graft is associated with a much decreased recurrence risk of 5%-10%.

Surgical complications may also include corneal scarring and perforation of the white part of the eye. In some cases, surgical removal of pterygium can cause astigmatism.

Patients need to be carefully followed for a year. About 97% of recurrences happen during the first 12 months after surgery.

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