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Pterygium surgery in Goa: the growth on the white of the eye

Many people in Goa notice a pink, fleshy patch on the white of the eye, usually on the side nearest the nose, slowly creeping onto the clear front of the eye. This is a pterygium (said "te-RIJ-ee-um"), sometimes called surfer's eye. It is not a cancer and does not spread to other parts of the body, but it can irritate the eye, look red and, if it grows far enough, blur vision. Because other growths can look similar, the eye doctor examines any growth on the eye to be sure what it is. This page explains why a pterygium forms, when surgery is worth it and what to expect.

Why is pterygium common in Goa?

Pterygium is far more common in sunny places close to the equator, and in people who spend years outdoors. Ultraviolet (UV) light from the sun is thought to be the main cause, with wind, dust, sand and salt spray adding to the irritation. In Goa that means fishermen and boat crews, port, dock and construction workers, farmers, traffic police, delivery riders and anyone who rides a scooter every day. Sunlight reflected off the sea, the sand and wet roads adds to the exposure. It usually starts in adult life, becomes more common with age, and often affects both eyes.

A smaller, yellowish raised spot on the white of the eye that stays off the cornea is usually a pinguecula, a related sun-linked change that rarely needs surgery.

What symptoms does a pterygium cause?

• a visible pink or red fleshy growth, usually on the nose side of the eye
• redness that flares up with sun, wind, dust or smoke
• a gritty, burning feeling, as if something is in the eye
• watering and dryness
• blurred vision, if it pulls on the cornea and causes astigmatism, or grows over the centre
• discomfort with contact lenses

Many small pterygia cause few symptoms and simply need watching.

Do I need surgery?

Not always. The eye doctor examines the pterygium under the slit lamp microscope, notes how far it reaches onto the cornea, and checks your vision, spectacle power and astigmatism. Surgery is usually advised when:

• the pterygium is growing towards the pupil, at the centre of the cornea
• it is blurring vision or changing your spectacle power
• it stays red and irritable despite drops and sun protection
• it limits eye movement or gets in the way of contact lens wear
• its appearance troubles you, after you have weighed the chance that it may grow back

Removing a pterygium before it reaches the centre of the cornea avoids the scarring and blur that can remain after a large one is removed. If surgery is not needed yet, lubricating drops ease the grittiness, sunglasses and a cap with a brim cut down the sun on your eyes, and the pterygium is checked at intervals to see whether it is growing.

What happens in pterygium surgery?

Pterygium surgery at ReNew Vision is a planned operation under local anaesthesia. You are awake, and most people go home the same day.

1. Before surgery. The eye is examined and the operation explained. Tell the team about your general health and all your medicines, especially blood thinners, and ask which ones to continue.
2. Numbing. The eye is numbed with drops, and sometimes an injection beside the eye. Most people feel touch or pressure rather than pain during the operation.
3. Removing the pterygium. The growth is carefully removed from the cornea and the white of the eye.
4. Covering the bare area. Because a pterygium can grow back, the bare area is commonly covered with a thin graft of your own conjunctiva (the clear skin over the white of the eye), taken from under the upper eyelid and held in place with fine stitches or tissue glue. This lowers the chance of regrowth compared with leaving the area bare. Your surgeon explains the method planned for your eye.
5. Finishing. The eye is usually padded until the next day.

The operation usually takes well under an hour. Because the eye is padded afterwards, do not drive yourself home. We can collect you from your home and drop you back, at zero cost to the patient; ask about this when you plan the date.

What is recovery like?

• For the first few days the eye usually feels sore, gritty and watery, and looks red. This settles over one to two weeks, though the redness can take several weeks to fade completely.
• You use prescribed eye drops for some weeks, exactly as advised, and come back for check-ups. Some of these drops can raise eye pressure in some people, which is one reason the check-ups matter.
• If stitches were used, they either dissolve or are removed at a check-up.
• Do not rub the eye. Keep dirty water, soap and dust out of it, and avoid swimming and the sea until the eye doctor says the eye has healed.
• Many people go back to office work within a few days, and to dusty or outdoor work after a week or two, as the eye doctor advises.
• Wear sunglasses outdoors, to protect the healing eye and to lower the chance of the pterygium returning.

Can a pterygium come back?

Yes. Regrowth is the main drawback of pterygium surgery, and when it happens it is usually within the first year. It is more likely in younger people, with large or very red pterygia, and with continued heavy sun exposure. A graft of your own conjunctiva, using the drops as advised and protecting the eye from sun and dust all lower the chance. Keep your follow-up visits so that any regrowth is seen early.

What are the risks?

Pterygium surgery is a common, well-established operation, but like any surgery it has possible risks, which the surgeon explains before you agree to it. They include regrowth, redness or a small lump where the graft was placed, the graft moving out of place, infection, and raised eye pressure from the drops used afterwards. Serious problems are uncommon. Come back at once if the pain increases, your vision drops or the eye discharges after surgery; emergency eye care at ReNew Vision is available 24 hours.

Protecting your eyes from the sun

Whether or not you have a pterygium, sunglasses that block UV (labelled UV400, or blocking both UVA and UVB), worn with a cap or hat with a brim, cut the sun reaching your eyes. They may lower the chance of a pterygium starting or returning, although nothing can promise that. Wrap-around frames also keep out wind and dust on a scooter. See sunglasses for Goa's sun.

Pterygium care at ReNew Vision

Pterygium check-ups are done in the Eye OPD, Monday to Saturday, 4 pm to 7 pm, and surgery is planned with you after the examination. ReNew Vision Eye Hospital is on the 2nd floor of the Pai Hospital building, Vaddem Merces Road, Vaddem, Vasco da Gama; see how to reach us. Call or WhatsApp 072489 88039. The fee for surgery depends on the size of the pterygium and the method used, and is explained at the consultation. If your eye is mainly red and gritty from dryness, see dry eye treatment; for other problems of the front of the eye, see red eye, dry eye and cornea care.

Questions patients ask

Can a pterygium be removed without surgery?

No. Drops can ease redness and grittiness, and sunglasses cut down the sun on the eye, but no drop or medicine makes a pterygium go away. If it needs to be removed, surgery is the only way.

Is pterygium surgery done under general anaesthesia?

Usually not. Adults normally have it under local anaesthesia: the eye is numbed with drops and sometimes an injection beside the eye, and you stay awake. Most people feel touch or pressure rather than pain during the operation.

How soon can I go back to work after pterygium surgery?

Many people return to office work within a few days. Outdoor, dusty or heavy work usually waits a week or two. The eye doctor advises you at the check-up, depending on how the eye is healing.

Will the pterygium come back after surgery?

It can. Regrowth is the main drawback of pterygium surgery and usually happens within the first year, if at all. Covering the area with a graft of your own conjunctiva, using the drops as advised and wearing sunglasses outdoors all lower the chance.

Is a pterygium the same as a cataract?

No. A pterygium grows on the surface of the eye, over the white and the cornea, and can be seen in a mirror. A cataract is a clouding of the lens inside the eye, behind the pupil. Both are linked with sun exposure, and some people have both.

This page is general eye-health information, not personal medical advice. Your eye doctor advises you after examining your eyes.