QUESTION
My 25-year-old daughter recently had blurry vision, and her ophthalmologist said it was caused by something called a pterygium. She said there isn’t any treatment. Is that true?
ANSWER
Not exactly. Your daughter may not need treatment if the growth on her eye (called a pterygium) isn’t getting bigger. But if it gets large enough to interfere with her vision or she finds it cosmetically unacceptable, she will require surgery.
Most people have never heard of a pterygium, which actually is a relatively common eye condition. It is a benign, fleshy growth on the clear cornea covering the pupil. A pterygium slowly grows from the white portion of the eye (sclera), usually starting on the nasal side, and gradually moves toward the center of the pupil. It is typically visible to the naked eye, appearing as a slightly reddish film, before it causes any symptoms, including blurry vision and an itchy, burning sensation. At times, it will stop growing and remain small so that it can be observed yearly to be certain that it is no longer advancing.
We don’t know why some people develop a pterygium, but exposure to ultraviolet (UV) light is thought to be a major factor. It’s more common in surfers (that’s why the condition is sometimes called “surfer’s eye”), golfers, farmers and others who spend a lot of time outdoors—especially in sunny climates. Exposure to irritants in the air, such as pollen, smoke and wind, also raises risk for pterygium.
The condition is uncommon in young people, but I have seen it in an 18-year-old who was an avid surfer and did not wear sunglasses. Wearing UV-protective sunglasses—even on cloudy days—can reduce the risk of getting a pterygium and can also slow the progression once a growth has formed.
Even though a small pterygium can cause blurry vision or itchiness in the eye, it rarely impairs vision unless it continues to grow toward the edge of the pupil. Prescription corticosteroid eyedrops can ease eye irritation but will not slow progression. However, these eyedrops have potentially serious side effects, so they are to be used only on a short-term basis—if at all.
Over-the-counter decongestant eyedrops, such as Vasocon, Opcon and Naphcon, can reduce inflammation and redness. A relatively new eyedrop called Lumify is being touted for its significant “eye-whitening” effect. None of these products, however, will stop the pterygium from growing. While these eyedrops are generally safe, they should not be used long term without consulting an eye professional due to risks for rebound redness. Lumify reportedly has less risk for this side effect.
Your daughter’s ophthalmologist should do periodic eye exams to track any growth of her pterygium. These exams typically include taking photographs of the eye and measuring curvature changes in the cornea.
If your daughter’s vision is affected or she develops astigmatism (an irregular-shaped cornea that can lead to blurry vision), surgery may be recommended. This is an outpatient procedure performed with local anesthesia. It has few risks, but in many cases, a pterygium can grow back.
To reduce the risk for regrowth, a conjunctival transplant (the conjunctival membrane from the upper portion of the eye under the eyelid is removed and attached where the pterygium was removed) is an option. An amniotic membrane from a placenta can sometimes be used instead of conjunctiva.
Ophthalmologists who have been fellowship-trained as corneal specialists are the most qualified to perform this surgery. Patients can ask their regular eye doctor to recommend a surgeon.
Important: Blurry vision can have a number of causes, including nearsightedness, farsightedness, dry eye and cataracts—as well as medical conditions such as diabetes, multiple sclerosis and even stroke (often occurring with double vision and other symptoms). Always consult a health-care provider if you experience unexplained blurry vision.
To learn about other eye symptoms that can signal an emergency, read here.
