What Is Pterygium (Surfer's Eye)?

Medically Reviewed by Zilpah Sheikh, MD on February 13, 2024
7 min read

Though it's named for a certain type of athlete, this common eye growth can affect anyone who spends a lot of time outdoors.

The main symptom of surfer's eye, or pterygium (pronounced tur-IJ-ee-um), is a triangular growth of pink, fleshy tissue on your conjunctiva. Your conjunctiva is the clear tissue that lines your eyelids and covers the white of your eye. Surfer's eye usually forms on the side closest to your nose (at the 9 o'clock position) and grows across your eye toward your pupil area. It can sometimes grow at the 3 o'clock position, on the outside of your eye, as well.

It can look scary, but it isn't dangerous. The growth might spread slowly during your life or stop after a certain point. In extreme cases, it can cover your pupil and may cause vision problems.

The growth could show up in one eye or both. When it affects both, it's known as a bilateral pterygium.

Though it isn't usually a serious condition, it can cause annoying symptoms. You might feel like you have something in your eye. Or it may get red and irritated and require medical or surgical treatment. You might also feel self-conscious because people may ask you about your eye being red all the time.

Pinguecula vs. pterygium

Pinguecula (pronounced pin-GWEK-yoo-la) and pterygium are both growths on your conjunctiva. However, pingueculae are usually yellowish growths that may be filled with protein, fat, or calcium. Like pterygium, they usually grow on the side closest to your nose, but they don't typically grow onto the cornea, which is the clear, dome-shaped covering over your iris and pupil. You get a pinguecula the same way as a pterygium—lots of time outside in the sun and wind without eye protection. But pingueculae don't usually cause symptoms, and they don't need to be removed.

The first time you get it, your doctor will grade it based on how much of your cornea is covered by the pterygium. For instance:

  • Grade 1 grows over the white part of your eye and into your iris (the colored part of your eye)
  • Grade 2 grows onto your iris and is about halfway to your pupil (the black part at the center of your iris)
  • Grade 3 grows all the way across your iris and into your pupil

Sometimes, there are none—it just shows up. Sometimes, before it appears, you might notice a related growth called a pinguecula.

When you do have symptoms, they can include:

  • A raised pink growth on your eye that may keep getting bigger
  • Red, irritated, or swollen eyes
  • Dry, itchy, or burning eyes
  • A feeling that you have sand or grit in your eye
  • Eye watering and tearing
  • If the pterygium grows onto your cornea, blurred or double vision

Surfer's eye is an overgrowth of your conjunctiva tissue, and it's usually caused by:

  • Long-term exposure to ultraviolet light from the sun
  • Eye irritation from hot, dry weather and wind and dust

You may be more likely to get it if you live in the "pterygium belt," which is 37 degrees north and south of the equator, and work outside a lot. In the U.S., this includes states south of a line that runs from Richmond, Virginia, to San Francisco, California. This "pterygium belt" also includes:

  • Central America and most of south America
  • The entire continent of Africa
  • Countries in south Asia, such as Saudi Arabia, Iran, Pakistan, Nepal, India, Thailand, Vietnam, Philippines, Papua New Guinea, and the southernmost part of Japan
  • Australia

Your eye doctor will perform a thorough examination of your eyes, including:

  • Visual acuity tests that measure how sharp your distance vision is
  • How well you can move your eyes up, down, and side-to-side
  • Corneal topography that uses a computer to make a 3D map of the surface of your cornea
  • Slit lamp analysis that lets your doctor see both outside and inside your eyes

Your eye doctor may also perform tests to help them find out if your eyes make enough tears to keep your eyes moist.

You may not need treatment if you don't have discomfort or pain and it doesn't interfere with your vision. Your eye doctor may have you come in for regular appointments so they can see if it's growing and screen you for vision problems.

If you have discomfort, pain, redness, itching, or swelling, your eye doctor may:

  • Suggest you use over-the-counter (OTC) eye ointments or wetting drops, artificial tears, or decongestant drops
  • Prescribe steroid eye drops

Best eye drop for pterygium

The best eye drops for you will depend on what your symptoms are. If you have irritation, a feeling of having something in your eye, and tearing, OTC eye ointments and artificial tears may be the most helpful. If you have swelling, steroid eye drops will likely be the most helpful. If you have all these symptoms, using both eye ointments and steroid eye drops will likely give you the most relief.

You may need pterygium removal surgery if:

  • Eye drops don't help your symptoms
  • The pterygium grows large enough to block your vision, cause an astigmatism (a curvature in your cornea that causes blurry vision), or limits your ability to move your eye
  • You aren't happy with the way your eye looks

There are several types of surgery that work for pterygium. These include:

Excision with conjunctival autograft. This is the surgery eye doctors most often use because it has the lowest risk of the pterygium coming back. During this surgery, your pterygium is removed and some healthy conjunctiva from your eye (usually behind your upper eyelid) is sewn over where the pterygium was removed. Another variant of this surgery is called pterygium extended removal followed by extended conjunctival transplantation (PERFECT), which is a more complex surgery, but it has an even lower risk of the pterygium coming back.

Excision with amniotic membrane graft. This surgery is done the same way as excision with conjunctival autograft, except that a piece of amniotic membrane from the donated placenta of a recently born baby is used instead of your own eye tissue. Your doctor will likely choose this surgery if you may need another eye surgery.

Simple excision with bare sclera or conjunctival closure. In this surgery, your pterygium is removed, but no tissue graft is placed over the area. This has a high risk of the pterygium coming back, so it's not used as often as the other methods of surgery.

To reduce the risk of the pterygium coming back, your doctor will likely prescribe medicine to use after your surgery, such as:

  • Steroid eye drops for a few weeks or months
  • Mitomycin C
  • 5-fluorouracil

The procedure typically takes 30 minutes to an hour. You'll probably wear an eye patch for 1 or 2 days afterward, and your eye will feel uncomfortable and scratchy. You can return to work or normal activities in a few days. Pay careful attention to your eye for the next year. Most pterygium come back within the first 12 months after surgery.

Complications of pterygium surgery

Like any surgery, there may be complications. These include:

  • The pterygium comes back
  • Development of a cyst or infection
  • Double vision that may need surgery
  • Feelings of dryness or irritation
  • Scleral or corneal melting, which is when the collagen breaks down in your cornea and makes it thinner

There are several things you can do to prevent surfer's eye, slow its growth if you have one, and keep from getting it again after surgery, including:

Wear sunglasses and a wide-brimmed hat to protect your eyes from ultraviolet light. Choose shades that block 99%-100% of both ultraviolet A and ultraviolet B radiation. Wear them even on cloudy days. Wraparound styles provide the best shield against ultraviolet light, dust, and wind. Wear them when you're in the car, too. Unlike the windshield, your car's side windows don't protect you from ultraviolet rays. You can also apply a protective film to your side windows to help protect you when you're driving.

Use artificial tears to keep your eyes moisturized, especially if you live in a dry area.

How long does pterygium last?

Generally, pterygium doesn't go away on its own. The only way to completely get rid of it is to have surgery. But eye ointments and drops may help it look and feel a bit better.

Can I wear contacts if I have pterygium?

As is the case with most eye conditions, you probably shouldn't wear your contact lenses when you have any kind of discomfort, redness, or swelling. It can make your symptoms worse. To be sure, ask your eye doctor if it's okay for you to wear them.

Can pterygium cause blindness?

It's possible but rare to get blindness from pterygium. It may block or blur your vision if it keeps growing across your pupil. Sometimes, it can cause large scars on your cornea, which can cause blindness. However, most cases aren't this severe.