Overview
A pterygium is abnormal thickening and growth of the tissue (conjunctiva) overlying the white part of the eye (sclera), and extension of this growth onto the cornea.
It is most commonly found on the side of the eye adjacent to the nose, and is often noticed as a redness that is gradually increasing in size.
Pterygium can cause poor aesthetic appearance, reduced vision, astigmatism, eye redness and irritation.
Causes
Though the exact reason is not known, it is postulated that pterygium occurs due to hyperplasticity or excess growth of the limbal epithelial cells along with vascularization or formation of blood vessels over it that gives it its pink appearance.
The most common risk factor for pterygium is excessive exposure to sunlight. Other risk factors include older age, male gender, outdoor occupation, certain ethnicities and living in rural environments.
Diagnosis of the Pterygium
Before you look for pterygium treatment in London, it is important to first arrive at a conclusive diagnosis about the pterygium. A thorough slit lamp examination can make a diagnosis of the pterygium to check the cornea, conjunctiva, and limbus through a microscope. Fluorescent staining of the eyes and Shimer’s Tests are done at this point as a part of the diagnostic procedures. The aim is to check the level of irregularities and dryness caused due to the pterygium.
During this period, a visual acuity test is done to check the possibilities of astigmatism caused by the invasion of the fleshy pterygium over the corneal surface. If required, Corneal Topography and an occasional biopsy can also be advised by the surgeon to see the status of the cornea along with ruling out cancerous lesions before the surgery. The eyes may be photographed as a part of the diagnostic procedure to check the improvement post-surgery.
Phases of Pterygium Treatment
A pterygium can result in eye redness, foreign body sensation, blurred vision or double vision (as it causes astigmatism). Pterygium can worsen vision but extending into the cornea, resulting in increased astigmatism and may even block the view through the pupil. Irrespective of the clinic you visit for pterygium treatment in London, there are usually three treatment modalities for pterygium.
01) Prevention
Exposure to the sun and eye dryness may result in inflammation of the pterygium, which can worsen symptoms such as eye grittiness, soreness and wateriness. Keeing the eye lubricated may help to allerviate eye symptoms. Wearing sunglasses or photochromatic glasses may also help in some cases.
2) Medication
Pterygium often leads to uneven distribution of the tear film over the eye resulting in dryness and grittiness sensation of the eyes. Additionally, exposure to outside weather tends to inflame the blood vessels causing redness with foreign body sensation with occasional watering sensation. Lubricating eye drops (artificial tears) and certain medicated eye drops can be highly effective in treating pterygium symptoms. In this regard, you can always talk to an expert ophthalmologist at Harley Vision, London, if you want to avoid the surgery and look for an alternative way to manage the condition.
3) Pterygium Surgery – No stitch technique
Pterygium Surgery involves the removal of the pterygium, usually under local anaesthesia. Less commonly, some patients opt for sedation or general anaesthesia.
Pterygium surgery can be performed for a number of indications, including:
1. Improve eye discomfort (e.g. foreign body sensation, eye soreness)
2. Restore vision (e.g. reducing induced astigmatism)
3. Avoid further pterygium extension onto the centre of the eye
4. Improve cosmetic appearance of the eye
Pterygium surgery involves the following surgical steps:
1. Local anaesthesia to the eye
2. Surgical excision (removal) of the pterygium
3. A conjunctival autograft is acquired (from the same eye) to replace the pterygium
4. Conjunctival autograft is applied onto the original pterygium site using a modern adhesive tissue glue
5. Rarely tiny sutures may be used in addition to glue, but this is uncommon
There may be additional steps involved if the operation is being performed on a recurrent pterygium, such as application of a special chemical (e.g. Mitmoycin C).
The healing of the eye after pterygium surgery takes 3-4 weeks with minor discomfort. You will be advised to regularly use eye drops to minimize discomfort and optimise eye healing.
If you need a trusted clinic specialising in pterygium surgery in London, Harley Vision is a highly specialist clinic with excellent reviews. We have a high success rate because highly experienced ophthalmic surgeons perform the surgery. We use the latest state-of-the-art treatment modalities to make the whole process easy and hassle-free for you.
Frequent asked questions (FAQs):
Pterygium surgery is indicated if you have eye discomfort or blurred vision despite conservative measures such as using artificial tears (lubricating eye drops). Pterygium surgery may also be indicated to prevent further pterygium growth, as delayed surgery may fail to improve vision adequately due to residual scarring.
Common indications for surgery include:
- Gritty eye
- Foreign body sensation in the eye
- Eye soreness or pain
- Watery eye
- Blurred vision
- Double vision
- Red eye
- Poor cosmetic appearance
It is best to consult a specialist in pterygium surgery who will help you decide whether or not to undergo pterygium surgery. The specialist can also prescribe you eye drops or give you advice that may alleviate the need for pterygium surgery.
Often a pterygium may not require treatment. Intermittent irritation and redness is often successfully treated with lubricating eye drops (artificial tears).
Occasionally, a short course of steroid eye drops is used if there is significant inflammation.
Surgery is an option when the pterygium interferes with vision, causes persistent discomfort or inflammation or is making the eye appear abnormal.
Surgery is most frequently performed under local anaesthesia, but can be performed under sedation or general anaesthesia. The eye can be sore and red after the surgery for a couple of days. Using the drops prescribed by your doctor after surgery is important to minimise risk of infection and inflammation.
We are not certain about the exact cause of pterygium, and therefore have no definitive way to prevent it.
Risk factors for pterygium formation include. This condition is very common in people who are persistently exposed to excessive sunlight (i.e. UV light). It is more frequently seen in those who have lived in sunny areas of Far East Asia, Central Asia, Middle East, Africa and South America.
Therefore, wearing protective eyewear such as sunglasses or photochromatic eyeglasses may be of benefit, particularly in sunny environments.
A pterygium will result in a triangular pink bump on the white bit of the eye, and can grow onto the clear window of the eye (cornea). It can cause intermittent irritation and redness. A pterygium can worsen eyesight by growing onto the central cornea, or by altering the shape of the eye surface (astigmatism).
A pterygium is diagnosed by clinical examination during your clinic consultation. High resolution scans or tissue biopsies may be needed to rule out more serious conditions.
A pterygium can recur after surgical removal. However, modern techniques in pterygium surgery have significantly reduced the recurrence rate from 80-90% down to about 5-10%.
The rate of recurrence is influenced by several factors. For example, it is much higher when removing a recurrent pterygium (one which was operated on before), or in certain ethnic groups (e.g. Hispanics).
Pterygium can cause severe corneal scarring and the resulting decrease in vision if not treated timely. Timely treatment of the condition reduces the chance of scarring and vision loss to a great extent. Regular screening can also help in the early identification of the problem and help in its subsequent treatments.
Pterygium and Cataracts are two completely different eye conditions.
A Pterygium occurs on the front outer layers of the eye. Pterygium is abnormal tissue growth of the conjunctiva onto the normally clear and transparent layer called the cornea. Pterygium may or may not affect vision. As it occurs on the front surface of the eye, it can cause eye discomfort symptoms such as eye soreness or foreign body sensation.
A cataract is not a disorder of the front surface of the eye. Rather, a cataract is clouding of the natural crystalline lens inside the eye. Unlike pterygium, cataract formation is more likely to affect vision, especially as the cataract becomes more advanced. Cataract, on the other hand, does not cause symptoms such as foreign body sensation because it is not located on the surface of the eye.
Pterygium Surgery is a minimally invasive procedure that takes 20-30 minutes. At Harley Vision, pterygium surgery is usually performed under local anaesthesia using a no stitch technique. If sedation or use of stitches is needed, then often does not significantly increase the time of surgery.
After pterygium surgery, you can go home on the same day.
You can rejoin normal work in a few days after the surgery but will be required to refrain from heavy exercising or swimming for about 2 weeks or so. You can take showers but will have to avoid getting water or shampoo inside your eyes. You will also need to avoid eye makeup for a few days after pterygium surgery.
Pterygium can be covered by your private healthcare insurance if it is causing eye discomfort or worsening your vision. As with any medical condition, you pre-authorisation from your private healthcare insurance before undergoing surgery.
Irrespective of the clinic you visit for pterygium surgery in London, the cost will vary depending on a number of factors. For example, it depends on the size, thickness and the number of pterygiums growing on the eye. It also depends on the type of anaesthesia or sedation you opt for, and if biopsies need to be sent to the lab to rule out more serious causes. In case, you want to know an approximate cost of your pterygium surgery, get in touch with Harley Vision in London, today. You can also visit the ‘fees’ section of our website for an approximate cost.