A pterygium (Spanish: carnosidad) is a triangular proliferation of connective tissue and blood vessels originating in the nasal conjunctiva and extending onto the cornea. They are caused by exposure to ultraviolet light, wind, dust, and smoke. Pterygiae are common in areas approaching the equator where sun exposure is maximized and rare in cold climates. It has been postulated that hereditary factors may be involved.
Treatment is usually sought for inflammation, tearing, foreign body sensation, and cosmetic disfigurement. Visual disturbances may result if the pterygium grows over the limbus onto the surface of the cornea towards its apex. There may be in increase in or disruption of the tear film and corneal topography is useful to document such findings. In the senior author’s experience (LS) with over 1000 surgical cases, less than 5% present with visual symptoms attributable to the pterygium.
Symptomatic relief may be attempted with the use of over the counter (OTC) vasoconstrictors or artificial tears. This sometimes will spare some patients surgery is they only have occasional foreign body sensation or other very mild symptoms. Ophthalmic corticoteroids or non-steroidal anti-inflammatory (NSAID) may be appropriate for episodic relief of inflamed pterygia.
For small asymptomatic pterygiae or pinguecula avoidance of ultraviolet exposure with use of sunglasses is often the only recommendation given.
When medical treatment or eye drops don’t work, surgical treatment may be an option.
Dr. Stone has treated over 1000 pterygium patients and is a thought leader in Chicago for this disease. For instance he was the first ophthalmologist in the city to do beta radiation for his pterygium patients. And, he also was an early proponent of Mitomycin-C surface application and lectured on this at various seminars.
Most recently, he has been on the vanguard in using fibrin glue to affix conjunctival grafts to the sclera. He devised and published a hybrid suturing and fibrin glue technique—the new “gold standard” for pterygium treatment: Hinge Modification of “Cut and Paste” Pterygium Surgery. This method is the most anatomically correct way to correct the problem. After the pterygium growth is removed, your own tissue and amniotic membrane is used to cover the area of the eye which is now bare. This result in fast healing and eyes are comfortable the day after the procedure!