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Surfer’s Eye (Pterygium): Signs & Removal Options
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A pterygium might look strange or disconcerting, but it is usually benign. This wedge-shaped growth or bump, which contains blood vessels, does not often cause much harm to the eye unless it goes untreated.
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Pterygia are correlated with consistent exposure to ultraviolet radiation, usually from being outside. If you do nothing about them, they may cause vision loss or astigmatism. Fortunately, they are easy to diagnose through a routine eye exam.
You may receive special eye drops to manage any redness or itchiness you experience, but the primary method of treating pterygia is removing them surgically. There is some risk of pterygium recurrence after surgery, no matter what procedure is used.
You should use any prescription eye drops your doctor provides, and wear UV protecting glasses while outside.
What Is a Pterygium? Who Is at Risk?
Pterygium is also called surfer’s eye because this issue develops in people who are consistently exposed to ultraviolet (UV) light. This condition causes an elevated, wedge-shaped, skin-like bump on the eyeball, and the bump contains some blood vessels.
The growth begins in the sclera, or the white part of the eye. Then, it moves in toward the center of the eye. If untreated, this growth can cover the cornea and limit vision.
It is also possible to develop multiples of these bumpy growths, called pterygia. This can depend on how often your eyes are exposed to UV light from the outdoors or another source without protection, and how susceptible you are to developing pterygia. Other potential causes of a pterygium are dust, wind, or eye disease.
This condition most often affects people between the ages of 30 and 50 years old. Having light skin and eyes puts you at risk for pterygia.
While these growths can reduce your vision if they are left untreated for a long time, they are easy to diagnose. They can be removed via surgery.
Can a Pterygium Become a Serious Problem?
Most people who develop pterygia may worry about what their eyes look like, but they experience few symptoms from the bump’s development. Larger or growing pterygia can cause:
- Itchiness in the eye.
- A burning sensation.
- A feeling like there is something stuck in your eye that you cannot get out.
A larger pterygium can start to cause vision problems, including:
- Astigmatism, or blurry vision because of a misshapen cornea.
- Higher order aberrations (HOAs), causing blurry vision.
Diagnosing a pterygium is simple. Your eye doctor will use a slit-lamp test, which is a common procedure during routine eye exams that allows your optometrist to see several parts of your eye, including the back. You may undergo additional tests like:
- Visual acuity test using a Snellen chart.
- Corneal topography, measuring the curvature of the cornea or changes to the cornea.
- Photo documentation, using specific pictures to track a pterygium’s growth.
It is rare for these growths to require immediate treatment, although your doctor may prescribe special eye drops to reduce itching, redness, and swelling from a small but growing bump. You may also receive a prescription for contact lenses that cover the growth, so others will not see it and the area will be protected from further UV exposure. If you have dry eye as a symptom from your pterygium, you may receive a prescription for cyclosporine.
You can pursue surgery to remove the pterygium for both cosmetic reasons and to keep your vision healthy. There are different types of surgery to remove these growths. Your eye doctor will work with you to determine which approach best meets your needs.
Even if you have a pterygium surgically removed, it is important to note that they are likely to recur, especially if you have ongoing UV exposure or oxidative stress. Recurrence rates range from as low as 5 percent to as high as 40 percent, depending on the medical study. There is a correlation between summer months and pterygium recurrence, likely due to the higher exposure to UV light.
Pterygium Management: Surgical Options
There are three basic approaches to pterygium surgery.
- Bare sclera technique: This involves removing the head and body of the pterygium and allowing the bare sclera to regrow on its own. While effective in removing current pterygia, this procedure has a higher associated rate of growth recurrence later. Recurrence rates fall between 24 percent and 89 percent, depending on the report.
- Conjunctival autograft technique: After removal of the pterygium, this technique involves taking a piece of the conjunctiva (the thin, transparent layer of tissue that lies over the sclera) and suturing that over the area where the pterygium was. This has a much lower rate of recurrence — from 2 percent to 40 percent.
- Amniotic membrane grafting: This type of graft helps to prevent scarring and inflammation after removing a growth like a pterygium from the eye. It seems to be a good alternative to using conjunctival tissue as a graft, although pterygium recurrence rates vary with this approach.
During any of these procedures, you can expect:
- Your doctor to numb your eyes to prevent discomfort.
- The surrounding area to be cleaned.
- To have the pterygium removed.
- To potentially receive a graft.
Once your surgeon has removed the pterygium, they will attach a piece of surface eye tissue to the impacted area using either surgical glue or sutures. Your surgeon will decide which works best for your eyes specifically, but there are some differences between these procedures.
- Sutures: The conjunctival graft with sutures is considered “the gold standard” for pterygium management. There is such a low rate of recurrence, and this operation has been around for years. However, the surgery can run between 30 and 40 minutes, which is considered a long time for an eye operation.
- Glue: Fibrin glue is sometimes used rather than sutures for grafts after a pterygium is removed. It is faster and simpler, so there is less time in the operating room, less postoperative pain and discomfort, and it is simpler for eye surgeons to use. However, this glue is more expensive than sutures.
After the operation, you could also receive a medication called mitomycin C, which is applied topically either at the end of the surgical procedure or immediately after it is complete. This medication will reduce the risk of a pterygium recurrence.
Postsurgical Management to Reduce Pterygium Recurrence
You can expect to have a few side effects after the surgical procedure, which should last no more than six months. These include:
- Eye redness.
- Discomfort in and around the eye.
- Blurry vision.
If these get worse, there is increasing pain or bleeding, or these issues do not go away over time, contact your eye doctor. If you notice rapid pterygium regrowth, you should also contact your eye doctor for immediate help.
Once surgery is complete and you are home recovering, you will use steroid eye drops for a few weeks. This helps to prevent regrowth and reduces swelling in the surgical area.
It is important that you take steps to prevent pterygia from growing back. Lifestyle changes include wearing sunglasses with UV protection and using special photochromatic lenses. You may need to wear special lenses for a few days or weeks after surgery, if your eyes are sensitive.
Ultimately, pterygia are not difficult to manage with surgery and some lifestyle changes like wearing UV protective glasses. These growths rarely lead to serious eye problems if they are treated. They are often simply considered benign growths initially, and surgery is only recommended when they begin to interfere with vision.
Getting regular eye exams is the best way for you and your eye doctor to keep up with the speed of pterygium growth if you choose to wait on surgery. See your eye doctor on a regular schedule to ensure proper management of the condition.
References
- Pterygium: What Is ‘Surfer’s Eye’? (August 2017). All About Vision
- What Is a Pinguecula and a Pterygium (Surfer’s Eye)? (August 2019). American Academy of Ophthalmology (AAO).
- Pinguecula and Pterygium (Surfer’s Eye) Symptoms. (August 2019). American Academy of Ophthalmology (AAO).
- Pterygium. (November 2017). Healthline.
- Management of Pterygium. (November/December 2010). EyeNet Magazine, American Academy of Ophthalmology (AAO).
- Amniotic Membrane Transplantation in the Human Eye. (April 2011). Deutches Arzteblatt International.
- What to Expect With Pterygium Surgery. (January 2019). Healthline.
- New Approach Emerges After for Pterygium Surgery. (February 2012). EyeNet Magazine, American Academy of Ophthalmology (AAO).
- What Is Surfer’s Eye? WebMD.
- Surfer’s Eye Overview. (September 2019). Verywell Health.
- A Radical Treatment for Surfer’s Eye. (March 2014). BMJ Case Reports.
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