Pterygium Surgery
Removal with a graft of your own tissue, to minimise the risk of recurrence.
Overview
A pterygium is a wedge of thickened tissue that grows from the white of the eye onto the clear cornea, usually from the side nearest the nose. It is not a tumour and it is not dangerous. It is not simply cosmetic either: as it advances it pulls on the cornea, distorts its shape and eventually reaches the line of sight.
It is common in this region because ultraviolet light, wind, dust and dry air are all recognised causes. Many pterygia never require surgery and are managed comfortably with lubricants and sun protection. The decision to operate is based on measurements — how far it has advanced, how much astigmatism it is causing, and how much irritation it produces — rather than on appearance alone.
When surgery is needed, the technique matters enormously. Simply removing the tissue and leaving the area bare allows the pterygium to grow back in a substantial proportion of cases, and a recurrent pterygium is more difficult to treat than the original. Covering the area with a small graft of your own conjunctiva, taken from beneath the upper lid where it is not missed, reduces that risk to a small fraction.
When to seek assessment
- A fleshy, often reddened growth extending onto the clear part of the eye
- Persistent redness that worsens in sun, wind or dust
- Grittiness, burning or a feeling of something in the eye
- Blurring or a new astigmatism as the growth reaches the cornea
- Difficulty wearing contact lenses comfortably
- Concern about the appearance of the eye
Diagnosis
How the assessment is made
Measuring the advance
How far the tissue has grown across the cornea is measured and photographed, so that progression can be judged objectively at the next visit rather than by memory.
Corneal mapping
A scan showing how much the pterygium is distorting the shape of the cornea. Rising astigmatism is often the clearest argument for operating before the growth reaches the pupil.
Tear film assessment
Dryness both aggravates a pterygium and slows healing afterwards, so the ocular surface is treated before any surgery is planned.
Confirming the diagnosis
Occasionally a growth on the surface of the eye is something other than a pterygium. Anything atypical in appearance or behaviour is sent for laboratory examination after removal.
Treatment
Options and what each one is for
Conservative management
For a small, quiet pterygium: preservative-free lubricants, sunglasses with genuine ultraviolet protection, and periodic photographs to confirm it is not advancing.
Removal with conjunctival autograft
The preferred operation. The abnormal tissue is removed and the bare area covered with a thin graft of your own conjunctiva, giving a low recurrence rate and a smooth, natural-looking surface.
Glue rather than stitches
Where suitable, the graft is secured with tissue adhesive instead of sutures. Recovery is noticeably more comfortable and the redness settles sooner.
Amniotic membrane grafting
For large or recurrent pterygia, or where the conjunctiva must be preserved for possible future glaucoma surgery, the defect is covered with amniotic membrane, which encourages healing with minimal scarring.
Adjunctive treatment in recurrent cases
Carefully selected additional treatment at the time of surgery to reduce the risk of the tissue returning, used only where the individual risk of recurrence justifies it.
Recovery
What to expect afterwards
First week
The eye feels scratchy and looks red, and waters for several days — this is expected. Drops are used regularly and the eye is protected from sun and dust.
Weeks two to four
Comfort returns quickly and most people are back to normal activity within a week. The redness fades gradually over about a month.
Three to six months
The graft settles and the white of the eye returns to its natural appearance. Review continues through this period, as recurrence, if it happens, occurs early.
Questions
Frequently asked
If your question is not answered here, it is welcome in consultation — or by message before you book.
Not always. Many remain small and stable for years and need nothing more than lubricants and sun protection. Surgery is advised when it is advancing towards the line of sight, distorting the shape of the cornea, or causing irritation that will not settle.