Eye diseases: what is pterygium?

By Cristiano Antonino Last updated Jun 16, 2023

Pterygium is a degenerative disease of the eye, affecting the ocular surface in particular. This disease consists of a fibrovascular outgrowth of the conjunctiva that progressively extends over the cornea, the transparent portion of the ocular surface, causing a great deal of discomfort

The particularity of this degenerative disease is its triangular shape

Pterygium is a disease that mainly affects the male sex, which is more affected than the female sex.

This disease does not always affect both eyes; on the contrary, it often affects only one of them, or it affects both but in different ways, with different stages of evolution.

Furthermore, age is also a factor to be considered, as this disease mainly affects people over 50, while it is very rare for it to affect people under 20.

Pterygium symptoms

Pterygium symptoms may differ between patients depending on various factors.

Initially, this disease does not present any symptoms: in the early stage there are few lesions in the eyes and they are often barely visible to the naked eye.

The causes are not completely known, but it seems to be favoured by sun exposure and chronic irritation of the ocular surface.

In many cases, pterygium can lead to severe redness and prominence, resulting not only in a blemish but also in severe discomfort.

The sensation that characterises pterygium is that of having a foreign body in the eye and thus of heavy tearing and burning.

In severe cases, this pathology can also lead to a distortion of the corneal surface, thus inducing astigmatism or reaching the optic axis.

In this case it is not unusual to also suffer from distorted, double-like vision.

Diagnosis and OCT of the Cornea

Pterygium is diagnosed by the ophthalmologist during the examination by means of a slit-lamp test.

If one wishes to examine the state of the cornea and assess any changes to the ocular surface also induced by the pterygium, the doctor can use these instruments

corneal topography test, with which the shape and characteristics of the cornea can be studied. In particular, this test allows the curvature of the surface to be measured by offering a map showing the points that are more or less pronounced. Usually the cooler colours correspond to the flatter points and the warmer ones to the higher ones. To do this test you sit on a stool and stare at a light source for a few seconds. The only preparation before the test is not to use contact lenses for at least 2 or 3 days;
computed optical tomography test, also called OCT, is another way to assess the morphology of the various corneal layers. This non-invasive test provides a scan of the cornea and retina that can detect many pathologies. OCT is used for preparatory and post-operative diagnosis but also to detect many corneal pathologies. The test lasts only a few minutes and even in this case the patient must sit in front of an instrument and a bright target;
finally, the endothelial count allows the state of the corneal endothelium surface to be studied and assessed. Thanks to the study of the endothelium cells, it is possible to examine their shape, size, density and variability.

Pterygium: Treatments

Today, there are different types of pterygium treatments, differing according to the severity of the disease and per patient.

If there is irritation of the eye and occasional inflammation without visual changes, lubricating eye drops or corticosteroids are administered.

Among the treatments for pterygium in the most severe cases where there is significant invasion of the cornea with initial visual changes is surgery, whereby this pathological tissue is now removed from the ocular surface restoring corneal transparency.

This operation usually lasts 45 minutes and the patient undergoes local anaesthesia to proceed.

The operation is not particularly invasive, but to prevent the high risk of a relapse of this disease, an autograft of the conjunctiva is usually performed. In this way, a healthy sector is taken from the patient’s eye and implanted in the exposed area.