Pterygium - Prevention, cause, symptoms and treatment

Pterygium

Pterygium is fleshy conjunctival membrane growth (has blood vessels) that cover the white area of the eye and slowly spread over the cornea. This growth is a kind of triangular shape. It may occur in one eye or both eyes. If it develops in both eyes called bilateral pterygium. Early-stage of pterygium is looked like pingecula, so sometimes it is difficult to differentiate between pterygium and pingecula.

Pterygium is a non-cancerous growth; sometimes this may disconfigure the eye cosmetically. Due to moderate to advanced pterygium growth person may experience redness, irritation, discomfort, and blurry vision. Pterygium grows very slowly but in very few cases it may grow rapidly.
Reason for occurrence - cause for pterygium occurrence is unclear. It could be due to overexposure to Ultraviolet rays, excessive exposure to dust and pollution. In case of dry eyes pterygium may increase. In case of injury or burn near black eyeball or its adnexa will also cause pterygium occurrence.

Stages of Pterygium

Stage 0: In this stage very small elevation appears near the black eyeball over the sclera. In this stage there is no vascularisation and conjunctival and corneal ectasia are seen.
Stage 1: In this stage small bump like mass touches the limbus.
Stage 2: In this stage bump flatten a little just on the limbus with minimal vascularisation.
Stage 3: In this stage the fleshy layer covers the area between the limbus and pupillary margin with minimal congestion and vascularisation. This stage is associated with mild to moderate astigmatism.
Stage 4: In this stage the fleshy layer reaches to central to the pupillary margin with severe congestion and dilation. This stage is associated with an increase in astigmatism and rarely leads to the limitation of eye movement.

Signs and Symptoms

Pterygium causes redness, itching, irritation, foreign body sensation, sometimes dryness in the eyes. Redness may increase when someone is exposed to air, dust, and pollution or drives without protective glass. Contact lens users may find discomfort due to poor fitting of contact lens in moderate to advanced pterygium conditions. The cosmetic appearance of the eye may not look good in the case of pterygium. Pterygium is stretching the front surface of the eye (cornea), which leads to astigmatism and higher-order aberrations which affects the quality of vision.

Treatment and prevention

• Avoid eye rubbing excessively.

• To wear protective glasses (covering full eyes).

• UV light protected glasses.

• Lubricants (eye moisten drops).

• Surgically (in case of moderation or advanced pterygium) - But recurrence rate is 2-5% after pterygium surgery. 

There are different techniques to remove pterygium surgically:
a. Pterygium excision with autologous conjunctival autografting
b. Pterygium excision with mitomycin C,
c. Pterygium excision with conjunctival limbal autograft
d. Pterygium excision with amniotic membrane transplantation

During the pterygium surgery fleshy mass is removed and replaced with a graft of associated membrane tissue to prevent recurrent pterygium growths. And this graft is attached either with sutures or fibrin glue, post pterygium surgery eye experienced lesser discomfort, and recovery time reduces with fibrin glue. But fibrin glue is having its own risk of transmitting infection (viral) and more inflammation.

Recovery time

Post pterygium surgery redness, irritation, foreign body sensation, and graft dissolving usually takes 6-8 weeks but this healing time may change due to the type of technique used during surgery.

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Eye care tips

Your Eye's good vision help you perform well – at home or at work. It is important to take few simple steps to make sure that your eyesight at its best. Periodic eye exam is the best way to maintain good eyesight. 

Your eyes are unique and have their own set of nutritional need.

Choose food which is rich in antioxidants like vitamin A and C, food like green leafy vegetables, omega-3 fatty acids (good for macula health – the central part of retina) as part of your healthy diet.

Inadequate intake of antioxidants, smoking, and consumption of alcohol or saturated fats may create free-radicals reaction that can harm macula as age grows older. High fat diets can deposit in retinal blood vessels and slow down blood flow in retinal blood vessels which can cause decrease or loss of vision.

Body and eye exercise improves blood circulation, which improves oxygen level in blood and eyes that removes toxins.

You should have sound sleep at night for 6-8 hours that will make your performance better at home or work and will support the health of your eyes.

Always keep your hand clean, it is very important especially when it comes to your eyes and mouth. If you are contact lens user, before insertion and removal of contact lens – wash your hands with mild soap and dry with a lint-free towel. Otherwise germs and bacteria that come from your hands can cause an eye infection, cold and fever because whatever is on your fingers goes right in to your eye’s surface and mouth.

Smoking exposure, may increase oxidative stress level, may be risky for health conditions too.

Everyone should use ultraviolet (UV) protected sunglasses to protect eyes from harmful UV light. Choose sunglasses with both UVA and UVB protection. Wearing peaked cap or hat will reduce the amount of UV radiation entering in to eyes.

We live in a technology-run world, which means that a lot of our time is spent in front of a screen. In everyday life, we can’t live without digital screen and our screen usage has been increasing day by day. These devices are exposing your eyes to blue light because the wavelength emitted is near the bluer part of the spectrum. Lutein and Zeaxanthin are eye nutrients, obtained from diet and supplements, that are concentrated in the macula (the central part of retina) and help filter blue light.

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Eye care tips for kids

There are several tips you can follow so that your child's eyes remain healthy and see clearly from birth through the teen years.

Eat right both during pregnancy and after so that your baby will be healthier.

Provide nutritious meals with fruits, vegetables, nuts, and fish (for non-vegetarian). These foods contain key antioxidants and nutrients such as vitamin C, vitamin, E, zinc, omega-3 fatty acids, and lutein, which are linked to eye health. 

Provide your child with age-appropriate toys that are free from sharp edges.

Give your child toys that encourage visual development.

Watch your baby for signs that the eyes are crossed or turned out/in.

Look at your baby for any dullness or whitish appearance in black eyeball.    

Provide sun protection means child should not look at sun while playing in outdoors, this may damage internal eye (retina).

Your child's eyes should be examined regularly, particularly during infancy and childhood.

First aid tips for eye injuries:

• If your child spills something in his or her eye and you don't know what it is, or if there is a chemical (acid or alkaline) substances in it, flush your child's eye with water for at least 15-20 minutes and seek ophthalmic consultation at the earliest.
• If your child is hit in the eye with a blunt object, examine the eye closely. If you see bleeding or unable to open the eyelids, seek ophthalmic consultation at the earliest.
• If your child continues to be in pain, constantly rubs his or her injured eye, has persistent tearing, or complains of blurry or double vision - in the meantime, cover your child's injured eye with a cold pack for 5-10 minutes every hour or so.
• If your child's eye is injured with a sharp object, do NOT press on the eye or eyelid. Cover the eye with a shield (the cut-out bottom of a foam cup would do) and seek immediate ophthalmic consultation. If the sharp object is still in the child's eye DO NOT remove it. Instead cover the eye with eye cup or shield.

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