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While the risks of ultraviolet (UV) radiation to the skin have received a lot of attention, exposure to UV rays can also lead to an eye condition called pterygium, popularly known as “surfer’s eye.”
Matthew Gorski, MD, an ophthalmologist at Northwell Health in Great Neck, New York, said MedPage Today that he sees several patients with pterygium every day – and that the vast majority of them are not surfers, but have other risk factors for infection.
“A pterygium is a very common fleshy growth on the cornea and conjunctiva. Some people call it ‘surfer’s eye,’ although it can certainly occur in patients who are not surfers,” Gorski said, noting that people who are exposed to a lot of UV radiation are most at risk. This includes people who spend a lot of time outdoors, as well as people who live near the equator, where UV radiation is stronger.
“The growth usually starts in the conjunctiva, and then you get this fibrovascular development – so blood vessels and fibers grow – and it can grow from the conjunctiva to the cornea,” he explained.
Wearing sunglasses with UV protection is crucial to preventing the formation and growth of pterygia, Gorski said. There are many cheap sunglasses with questionable UV protection available on websites like Temu and Amazon, but Gorski recommends buying glasses from reputable vendors to ensure maximum UV protection. He noted that keeping the eyes moist can also help, as a dry ocular surface can promote the growth of pterygia.
Patients with a pterygium often come to the office with a red, inflamed eye and may complain of irritation or a foreign body sensation. If the pterygium has grown significantly, the patient may notice a white patch on the eye. Pterygia can also be raised, which contributes to the scratchy, irritated feeling. Gorski noted that pterygia do not start in the central visual axis, but can grow over time and affect vision.
Treatment for a pterygium begins conservatively with lubrication through artificial tears and anti-inflammatory drops, but at a certain point, surgery is the only way to completely remove the growth. Researchers are actively looking for ways to shrink pterygia without surgery, such as with medicated eye drops, but there are no FDA-approved medications to treat this condition.
“If the pterygium becomes persistently red, inflamed and bothersome, or if it grows toward the central cornea and affects vision there, we recommend surgical removal,” Gorski said.
He described the removal surgery as low-risk; patients can come and go the same day, but full recovery takes several weeks.
“We carefully remove the ulcer from the surface of the eye and then use various techniques to cover the area where the pterygium was previously,” he explained.
One method is conjunctival transplantation, which uses a piece of conjunctival tissue from behind the eyelid to plug the hole. This method still leaves a wound on the eye, but in a more protected location. Another method is amniotic tissue transplantation, which uses donated amniotic membrane tissue from a placenta as a type of dressing while the eye heals. This technique is especially helpful for pterygia that is too large for autotransplantation, according to the Cleveland Clinic.
Pterygia is benign. However, to be on the safe side, the surgically removed growths are sent to pathology for examination to ensure that they are not cancerous.
Cancerous growths “can sometimes mimic a pterygium, so a thorough clinical examination is important,” Gorski said.
Part of this examination includes assessing the mobility of the lesion as well as looking for irregular pigmentation or irregular blood vessels. Conjunctival lissamine green may be used to stain the surface of the eye and look for these signs, which may indicate malignancy.
