An eye growth commonly found in people from warm weather climates may be affecting as many as 720,000 Floridians and others from warm weather states.

The growth, called a Pterygium (pronounced “tur-ridge-ee-um”) refers to a raised, wedge or wing-shaped growth of benign fibrous tissue, typically found on the inside (nasal side) of the cornea, or the clear “front window” of the eye.

Pterygia are nourished by tiny capillaries that supply blood to the tissue and may appear to be cream colored, yellow, gray, white, pink or red. Sometimes, they are colorless.

Causes
The exact cause of pterygia is not known. What is known is that occurrence is more common in tropical climates like Florida and in people who spend a lot of time in the sun. Exposure to Ultra Violet (UV) light seems to contribute to the formation of the growths.

In the United States, the incidence is 2% of the population, up to 4% in sunny climates like Florida and California. The incident rate rises even higher in more temperate climates. Near the equator, 20% of the population will develop pterygia.

Chronic irritation from wind and dust also may contribute to their formation and progression. Pterygia form almost exclusively in adults, and are found more commonly in men than women. There may also be genetic predisposition to pterygium development.

Nothing has clearly been shown to prevent pterygia. Because they are linked to UV light, it is wise to minimize exposure by wearing protective eyewear containing blockage against UV radiation. It also makes good sense to protect your eyes from irritants such as dust and chemicals, and see your eye doctor regularly.

Symptoms
For some people, the pterygium is small and becomes dormant – meaning it never progresses in shape or size. For others, the growth becomes large enough to affect the shape of the cornea, causing astigmatism. Astigmatism is a condition that causes the cornea to bend in an abnormal curve, resulting in blurry or out-of-focus vision.

If a pterygium moves into the central part of the cornea, it can obstruct vision and may require surgery.

Typically, the pterygium is first noticed on the conjunctiva, the delicate mucous membrane that covers the sclera, or white fibrous part of the eye. If the growth continues, then it moves gradually into the cornea.

When the growth is confined to the sclera it is known as a Pingueculum (pronounced “pin-gwek-you-lum”). A pingueculum most often forms on the side of the eye closest to the nose. Unlike a pterygium, a pingueculum does not grow onto the cornea. A pingueculum may become a pterygium, or it may never change and require no treatment at all.

Some people with pterygia do not experience symptoms and do not seek treatment. Others may complain of irritation, redness, tearing, dryness, light sensitivity and foreign body sensation.

A pterygium can look like a bump or film growing over the eye, and many patients become concerned about appearance. Pterygia can look similar to more serious eye growths, so it is important to have your eye examined by an ophthalmologist (eye specialist) to determine the root cause of the growth.

In most cases, a comprehensive exam will reveal even asymptomatic pterygia, meaning the growths may exist, but have not progressed to a state that requires medical intervention.

People with a defined pterygium should be seen by an eye doctor annually to monitor growth and prescribe treatment before it interferes with vision.

Treatments
Most pterygia grow very slowly and rarely cause long-term vision damage. Treatments depend on the size and symptoms.

In the early stages, a conservative approach may include the regular use of artificial tears and protection from the sun’s harmful UV rays. Wearing protective eyewear and a hat to cover eyes when outdoors is recommended. Occasionally, anti-inflammatory drops are required.

If a pterygium does grow over the cornea and threatens vision or causes persistent irritation, surgery may be recommended. Most patients with stable health can undergo pterygium removal without difficulty.

Surgical Options
A pterygium can be removed in a procedure room in your ophthalmologist’s office or in an operating room at an ambulatory surgery center. Your doctor will determine the setting and technique that best suits your needs.

Generally, an anesthetic is applied to numb the eye area. The eye is kept open while the growth is removed. The removal usually takes less than 60 minutes to complete, after which an eye patch is prescribed for a day or two.

After surgery, most people return to work and other activities within a few days. Eye drops or ointment applied several times a day is mandated during the healing process. The site may be red and swollen for a period of time, but most people do not experience visible scarring and only minor discomfort.

Recurrence
Pterygia have a high rate of recurrence. In some studies, up to 40% of patients experience another pterygium. Often, the new growth is larger and more aggressive than the original. To prevent regrowth, many different surgical techniques have been tried along with various adjunctive therapies, including radiation and inhibitory drugs.

Conjunctival autografting involves suturing a healthy piece of conjunctiva from a different part of the eye to the affected area. This technique has decreased recurrence rates to less than five percent.

A promising new technique that may replace the autograft procedure uses amniotic membrane transplantation with tissue adhesive to prevent recurrence.

David Weiser, M.D., is a board certified ophthalmologist with Florida Eye Associates. He sees patients in Melbourne and Suntree. For more information, call (321) 727-2020.