Pterygium Frequent Questions

If there is no recurrence, it is highly likely that within 6 months after the surgery, you will probably not be able to tell which eye has had surgery. If this surgery is on a pterygium that has already been removed, the cosmetic result may not be as good. However, you will still be left with visible normal blood vessels in the area that are vital to the health of the eye.

If it grows over the pupil, it can lead to scarring and blindness.  It is however unlikely that your pterygium could blind you but if it is neglected and grows it can seriously interfere with vision.

This is not a cancer but in about 10{60df113cd5a1cd00914727638812fb5300a840b86aa020a6e915251c64286fee} of pterygia there may be some findings that suggest a pre-cancerous change when the specimen removed at surgery is looked at by the pathologist. This does not mean that cancer will develop later on but reflects the excessive exposure to sunlight that is common to the development of pterygium and to cancer on the surface of the eye.  As this is rare and clinically the diagnosis is not in question, we do not send pterygium specimens to a pathology laboratory.   We find that it only drives up the cost of care.  If you wish and are concerned, we can send the specimen to the pathologist.  The cost of this evaluation may or may not be covered by your health insurance.

No, a cataract is an aging change that results in clouding of the focusing lens inside the eye. A pterygium is a change on the surface of the eye and is frequently found in much younger people that those that have a cataract. Cataracts normally affect vision as they progress.

If your pterygium is causing a distortion of your cornea (crystal window of your eye) it is possible that your vision may improve after successful surgery and as a result you will almost certainly need new glasses. Sometimes, scarring and distortion of the cornea may persist after even successful surgery with no  recurrence of your pterygium.   This problem and the blur is the result of irregular astigmatism and can often be treated with rigid gas permeable contact lenses.

Is unlikely that typical pterygia are inherited. However, family members frequently are exposed to similar amounts of sunlight and this may be the reason why other members have a pterygium.

This can be done or we can separate the removal of two pterygia on the one eye by at least 6-12 months so that there is complete healing of the area from which the graft is taken and a further graft can be taken from the same area for the second pterygium removal.  The other option is splitting the graft for both areas or using an amniotic membrane for one or both areas.

No.

If there are no unusual circumstances, the followup schedule is one day, one week, one month, and at three or four months after the surgery.

The period of  highest risk of the pterygium returning is in the first year. If there is a recurrence this should be picked up at the earliest possible time.  When treated early, the recurrence can be stabilized avoiding the necessity of a repeat operation.

I prefer that you return to me for followup as I have great experience in assessing the normal course of the eye recovering from pterygium surgery. However, if you live a long way away, it may be possible to handover the followup visits to your optometrist or ophthalmologist. You would need to have eye pressure measurements and other specialised eye examinations undertaken by your optometrist or referral ophthalmologist. I will usually request that you return to me for the final visit which may be up to one year after the surgery. This may be avoided in special situations.   Often a simple photo from a cell phone can suffice.

If this is the first removal of your pterygium, it will take about 20 minutes. If it has been removed previously it may take 1 hour.

There is no evidence to suggest that a pterygium removal should be restricted to a particular season.

There is no injection behind the eye, only an injection to the pterygium and graft sites.  This generally creates no issues or significant discomfort.

Different techniques and post operative compliance result in different recurrence rates.    Our technique results in about  5{60df113cd5a1cd00914727638812fb5300a840b86aa020a6e915251c64286fee} recurrence.   The rate is higher for eyes that have had previous failed surgery.

These are among the lowest recurrence rates reported in the scientific literature.

There is no evidence that wearing sunglasses after the surgery will affect the likelihood of the pterygium recurring. However, it is advisable to wear sunglasses anyway, to reduce the exposure of both of your eyes to sunlight exposure, and hopefully reduce the risk of developing cataracts and cancer on the surface of the eye at a later age. Both of these diseases are strongly related to sunlight exposure over many decades of life.

There is always a very small risk of infection which is the reason that you will be placed on antibiotic eyedrops for a week and asked to wear a sterile patch for showering or when entering a dirty environment for the first 2 weeks. Infection later than 2 weeks after surgery is very uncommon.

You will not be able to swim for about a month. You may have difficulty driving or working for a few days to a week because of temporary double vision and irritation.

No, but if you wish you can take approximately 1- 2 weeks off work after the surgery and we will provide you with a medical certificate for your employer if required, the day after your surgery.

Usually no tablets for pain are required and over the counter medications will suffice.

The surgery will be undertaken using a topical and local anaesthesia as well as intravenous sedation.   The eye will be patched and suprisingly there is little discomfort after surgery.

The removal of your pterygium required exposure of a muscle that turns your eye in towards your nose. The swelling around this area restricts the ability of this muscle to work fully for one to two weeks and so the eye will not turn in well for that time while your unoperated eye moves well.

Usually double vision will be gone by 1 week, although occasionally some double vision in looking to the extreme right or left, may last for a few months. This is usually not noticeable during normal eye activities.  If there is excessive scar tissue, there can be double vision that increases rather than decreasing over time.

Usually the redness will be gone within 4 weeks, although sometimes some blood or bruising on the white of the eye may persist for 8-12 weeks.

This will usually be gone by 2-4 weeks.

The swelling is usually resolved within 2-3 weeks.

We use no stitches with our modified technique.  We only use glue!  This reduces discomfort and inflammation.

This is to keep the eye clean during the time it takes for the eye to reform its lining and reduce the risk of infection and to allow the graft to become seated.   The patch only needs to be worn for 24 hours in most cases but a shield should be worn at night for 7 days to avoid inadvertently displacing the graft.

The removal of the pterygium may result in a return to normal curvature of your cornea (crystal window of the eye)  and this will mean that your old glasses will not be appropriate for the new curvature. If you did not wear glasses before the surgery, it is sometimes necessary to wear glasses afterwards.

One set of drops to be used for the first week are antibiotic drops to reduce the risk of infection until the lining heals over on the eye which takes about one week. The drops that are to be used for a total of nine weeks, are steroid or cortisone drops that are crucial in reducing the risk of your pterygium recurring and to speed the recover of the eye.

You will be on strong eye drops (every 4 hours while you are awake) for two weeks and then for a further 6 weeks at 4 times a day.

In a small proportion of patients the steroid drops can raise the pressure in the eye which can lead to glaucoma. Usually identifying the rise in pressure at the 4 week appointment and treating the pressure and then stopping the steroid drops, results in the pressure returning to normal. In a very small number of patients the pressure can stay elevated and this is a serious problem that will require treatment.

The costs of surgery vary from person to person and depend upon many factors including how often the pterygium has been removed if at all, if you have private insurance or not and your level of cover. Once you have had  your initial consultation we provide you with a full written quotation so you will know all the costs in advance of booking the surgery.