Pterygium

Pterygium is common in countries near the equator, including Singapore, where sunlight is intense throughout the year. Long-term exposure to ultraviolet (UV) light from the sun is considered the main cause, which is why the condition is sometimes called “Surfer’s Eye”.

People who spend long hours outdoors without UV protection, such as sunglasses, have a higher risk. Regular exposure to wind, dust, smoke, sand and pollen can also contribute.

Pterygium tends to develop in adults between 30 and 50 years of age and is rarely seen in children. People with lighter skin and eyes may also be at higher risk.

Not every pterygium needs immediate treatment. A small, stable pterygium that causes few symptoms can often be monitored over time, with regular checks to track whether it is growing.

Treatment may be considered when the pterygium causes ongoing redness, irritation, a foreign body sensation (the feeling of something in the eye), blurred vision, or becomes a cosmetic concern.

A pterygium that grows towards the centre of the cornea can distort its shape and affect vision, which is one reason it is assessed before it progresses.

A pterygium may look like a minor surface change, but it can continue to grow and alter the shape of the cornea. Over-the-counter drops may ease irritation temporarily, but they do not stop the growth or reverse it.

An eye specialist can assess how far the pterygium extends, whether it is causing astigmatism (an irregular curve of the cornea that blurs vision), and whether the cornea is at risk of scarring.

A specialist assessment also clarifies whether monitoring is enough or whether pterygium surgery is appropriate, and helps reduce the risk of avoidable deterioration in vision.

A pterygium is usually diagnosed during a clinical eye examination, which involves several steps:

1. Symptom Review: The doctor asks about your symptoms, how long they have been present, and any related sun exposure.
2. Vision Check: The doctor checks your vision to see whether the growth is affecting clarity.
3. Slit Lamp Examination: The doctor examines your eye under a slit lamp (a microscope with a bright light) to assess the pterygium’s size and corneal involvement.
4. Corneal Measurements: The doctor may measure your cornea to check whether the pterygium is causing astigmatism.

A pterygium can also be picked up during a routine eye screening, after which the doctor advises whether monitoring or surgery is appropriate.

Treatment for pterygium depends on the symptoms and whether the growth is affecting your vision or comfort:

Eye drops and ointment ease symptoms but do not remove a pterygium. When the growth blurs vision or becomes cosmetically obvious, surgery may be considered to remove it.

Pterygium surgery aims to remove the growth, limit further visual deterioration, reduce redness, and improve the appearance of the eye.

Pterygium surgery is usually performed as a day procedure, meaning you can return home the same day. The surgery typically takes around 30 to 45 minutes for the affected eye.

Once the eye is numbed with anaesthetic drops, the procedure involves a few key steps:

• Removing the Growth: The surgeon removes the pterygium from the surface of the eye.
• Taking a Graft: The surgeon takes a small piece of healthy tissue (a conjunctival autograft) from under your own upper eyelid.
• Securing the Graft: The surgeon places the graft over the bare area, securing it with tissue glue or fine stitches.

Using a graft, rather than leaving the area bare, helps lower the chance of the pterygium growing back.

At our eye clinic in Singapore, this procedure is performed by specialist ophthalmologists.

A pterygium is removed through surgical excision, where the growth is detached from the eye’s surface and the area covered with a graft. A laser is not a standalone treatment for pterygium and is not routinely part of the procedure.

A consultation can clarify which approach is appropriate for your eye and whether a laser has any role in your treatment.

Pterygium surgery is generally safe, though as with any procedure, there are some risks to be aware of:

• Recurrence: The pterygium can grow back, which is why a graft is placed to lower this risk.
• Infection: Eye surgery carries a small risk of infection, which is managed with prescribed drops.
• Scarring or irritation: Mild scarring, redness, or a gritty feeling can occur while the eye heals.
• Delayed healing: The graft site may take longer to settle in some patients.

Recurrence is the main long-term concern after pterygium surgery, and the risk varies between individuals. However, using a conjunctival autograft can potentially reduce the likelihood of recurrence compared with removing the growth alone.

Recovery after pterygium surgery covers the first few weeks of healing and the care that supports it:

Recovery varies between individuals, so treat the information above as a general guide rather than a definitive timeline.