Ocular Surface Repair

A pterygium is a fleshy, exaggerated growth of the conjunctiva (the clear, thin tissue) that lays over the white part of the eye. The growth extends on top of the cornea and has the appearance of growing over the iris. One or both eyes may be involved. The cause is not known, but it is more common in people with excess outdoor exposure to sunlight and wind, such as those who work outdoors, so it is thought that ultraviolet light exposure may have a role in causing this condition chance of this condition.

Symptoms and Treatment

The main symptom of a pterygium is a painless area of raised white tissue, with blood vessels on the inner or outer edge of the cornea. Sometimes a pterygium becomes red and inflamed and causes burning, irritation, or a foreign body sensation. A routine eye examination can confirm the diagnosis. Special tests are usually not needed.

No treatment is necessary unless the pterygium begins to distort vision, causes symptoms that are hard to control or is significant cosmetically. When medical therapy is inadequate the pterygium, may be surgically removed.

Surgical removal of a pterygium, even if it affects the cornea, is highly successful and uncomplicated. The procedure is performed under local anesthesia. The main concern in performing the procedure is to minimize the chance of recurrence. Often the visually apparent pterygium is like the tip of an iceberg, with extension beneath the conjunctiva. Thus successful excision requires meticulous pursuit of another diseased conjunctiva. Techniques now include the use of topical antimetabolites (Metomycin C), amniotic membranes and conjunctival autografts to improve post-operate aesthetics and minimize the possibility of recurrence. Additionally, instead of using dissolving sutures which may increase recurrence rates, grafts are secured using medically approved glue. This results in superior patient comfort and appearance post-operatively. Dr. Koster routinely performs such procedures at his surgery center in mid-town Manhattan.

A pterygium can return after it is removed. Patients who have had them removed should wear protective glasses and a hat with a brim to prevent the condition from returning. Furthermore, people with pterygium should be seen by an ophthalmologist each year so that the condition can be treated before it affects vision.