•Dr Priscilia Imade
WHAT IS PTERYGIUM?
Pterygium (plural: pterygia) is a benign, wing-shaped, fibrovascular growth of the conjunctiva that extends onto the cornea. It typically develops on the nasal side of the eye and may remain small or grow large enough to interfere with vision. Though non-cancerous, it can be cosmetically displeasing and functionally debilitating in advanced stages.
STATISTICS
• Global prevalence: Ranges between 1% to 30%, depending on geographic location, climate and occupational exposure.
• Higher prevalence in tropical and subtropical regions, known as the “pterygium belt” (between 37° north and 37° south of the equator).
• In Nigeria, rural populations and outdoor workers show a notably higher prevalence due to chronic UV exposure.
• Studies report a higher incidence in males compared to females, likely due to greater outdoor activity.
CAUSES
• Ultraviolet (UV) light exposure is the primary cause. Chronic exposure to UV-B rays induces changes in the limbal stem cells and conjunctival tissue.
• Dust, wind and dry climates exacerbate the condition.
• Chronic eye irritation or inflammation.
• Genetic predisposition also plays a role in some cases.
SYMPTOMS
• Redness and irritation of the eye
• Gritty or burning sensation
• Foreign body sensation
• Blurred vision (if it encroaches the visual axis)
• Visible growth on the white of the eye
• Dryness or watery eyes
• Cosmetic concern
TYPES OF PTERYGIUM
1. Atrophic Pterygium: Thin and non-vascularized; often asymptomatic.
2. Fleshy Pterygium: Thick, vascularized and may grow progressively; more symptomatic and likely to cause visual impairment.
RISK FACTORS
• Prolonged sun exposure without eye protection
• Occupations with outdoor exposure (e.g., farming, fishing, construction work)
• Age: More common in individuals aged 30-50
• Male gender
• Dry, windy and dusty environments
• Genetic predisposition
• Living in tropical regions
COMPLICATIONS
• Astigmatism due to corneal distortion
• Visual impairment if growth extends onto the visual axis
• Recurrence after surgical removal (especially without adjuvant therapy)
• Cosmetic disfigurement
• Ocular surface inflammation
TREATMENT
• Medical treatment: Lubricating eye drops and anti-inflammatory medications to relieve symptoms.
• Surgical treatment:
• Indicated for vision impairment, recurrent inflammation or significant cosmetic concern.
• Techniques: Bare sclera excision, conjunctival autograft, amniotic membrane graft.
• Use of Mitomycin C or fibrin glue helps reduce recurrence.
MANAGEMENT
• Early stages: Symptom relief with artificial tears and sunglasses.
• Advanced cases: Surgical intervention with close follow-up.
• Post-operative care: Anti-inflammatory drops, UV protection and regular monitoring to detect recurrence.
PREVENTION
• Use of UV-protective sunglasses or wide-brimmed hats
• Avoidance of excessive sun exposure, especially in high-risk jobs
• Protective eyewear in dusty, windy or chemical-exposed environments
• Regular eye examinations, especially for individuals in high-risk groups
OCCUPATIONS MOSTLY AFFECTED BY PTERYGIUM
• Farmers
• Fishermen
• Construction workers
• Street vendors
• Motorcyclists and traffic officers
• Athletes involved in outdoor sports
• Welders and those exposed to artificial UV light
