PTERYGIUM, pronounced with a silent P, is a fibrous, fleshy growth on
thesurface of the clear cornea, usually beginning on the inner aspect
of the eye. It is a degenerative change in normally existing structures.
It occurs most frequently in patients who are exposed to lots of sun,
wind,dust or harsh climates.
Most commonly seen in the tropics and in areas of
wide temperature swings, PTERYGIA are also seen in temperate climates
among individuals who work or spend much of their time outdoors. They
are three times more common in men than women.Dryness and exposure to
ultraviolet light seem to be important factors in their development.
They tend to be slowly progressive, but in many patients PTERYGIA are
stable and don't seem to cause problems.
Sometimes patients mistake PTERYGIA for cataracts, but
cataracts form behind the colored part of the eye in the lens, and are
not easily seen with the naked eye as are PTERYGIA.
Symptoms are not severe, but they may cause blurred vision,
irritation, or produce characteristic complaints of dry eyes, i.e.,
itching, a burning feeling, or a scratchy sensation.During times of
growth they appear swollen and red.The best form of therapy is prevention.
Wearing hats and dark glasses in bright sunshine are two helpful preventatives.
No treatment is necessary if the PTERYGIUM is not causing
any noticeable problems or symptoms. Drops may aid the dryness and the
intermittent inflammation associated with PTERYGIA.
If clear vision is threatened by the presence of a PTERYGIUM,
surgical excision is indicated. Other indications for surgery
are increasing astigmatism or a patient's desire for removal for cosmetic
reasons.Surgical removal is complicated by two factors:
1. PTERYGIA often recur, sometimes
quite rapidly after removal.Certain forms of radiation therapy and drops
are available to reduce thisrisk.Nevertheless, recurrence is a difficult
problem especially in areas ofhigh risksuch as in dry hot climates and
in tropical regions. The preventative measures mentioned above are critical
in the postoperative period. Rarely is corneal transplantation indicated
with recurrent PTERYGIA.
2. Despite adequate excision, symptoms
of dryness and irritation may persist.