Does pterygium come back after removal? What lowers the chance in Nigeria

What a pterygium is

A pterygium is a fleshy, triangle-shaped growth of the clear skin on the white of the eye, usually from the side nearest the nose, that slowly creeps onto the clear front of the eye. It is not cancer. It is strongly linked to sunlight, which the World Health Organization lists among the long-term effects of ultraviolet light on the eye, and to dust and wind. That is why it is common in people who work outdoors in Nigeria: traders, drivers, okada riders, farmers and builders.

It may be red, gritty, watery or itchy, especially in harmattan. Many small ones cause no trouble at all.

Why it grows back

When the growth is cut away, the area heals by laying down new tissue. If that healing is too active, the same kind of tissue grows back over the eye, sometimes faster and thicker than the first time. Regrowth is more likely in younger people, in fleshy, very red growths, and in people who go straight back to strong sun and dust without protection.

What lowers the chance of recurrence

Ask your surgeon how they plan to do the operation. The things that make a difference:

• A conjunctival autograft: a thin piece of your own healthy conjunctiva, usually from under the upper lid, placed over the area. This is the standard approach in mainstream eye surgery, and regrowth is much less likely than when the area is left bare
• Fixing the graft with tissue glue or fine stitches, as your surgeon prefers
• In some cases a drug applied during surgery to slow scarring, which your surgeon will explain if they use it
• Using the steroid and lubricant drops afterwards for as long as you are told, not stopping when the eye looks white
• Wraparound sunglasses and a wide-brimmed hat or cap outdoors, every day, for good
• Keeping follow-up visits so early regrowth is seen

When removal is worth it, and when it is not

A small pterygium that is not growing and does not bother you can usually be left, with lubricating drops for irritation and protection from the sun. Surgery is worth discussing when:

• It is growing towards the pupil, or has already reached it
• It is blurring your vision or changing your glasses prescription
• It is red, sore or gritty most days despite drops
• It stops you wearing contact lenses
• You are having cataract or other eye surgery and the surgeon wants it out first
• Its appearance bothers you, understanding the risk of regrowth

Signs it may be something else

Most growths on the white of the eye that look like this are pterygium. See a specialist promptly if the lump is raised and growing fast, bleeds, has unusual blood vessels or colour, or appears somewhere other than the usual side of the eye, because a few other conditions, including growths that need a biopsy, can look similar. A painful red eye with blurred vision is not pterygium and needs urgent care.

Common questions