Pterygium is an eye condition characterized by abnormal growth of tissue over the conjunctiva — the thin membrane covering the white part of the eye — that can advance over the cornea and interfere with visual perception.
The development of pterygium is associated, in part, with prolonged exposure to ultraviolet radiation. A study conducted in one Amazon community indicated that 57% of individuals who worked outdoors had the condition in grade 2, 93.3% in grade 3, and 100% in grade 4, while research on the Solimões and Gapura rivers indicated that 89.5% of affected patients worked outdoors – one of the highest rates in the world.
Dr. Guy Romaguera Cantu, an ophthalmologist, explains that pterygium forms as a chronic response to external aggressions, including ultraviolet rays, dust, wind and dry eyes. “It is a long-term inflammatory process that leads to proliferation of conjunctival tissue and, over time, invasion of the cornea.”
The doctor explains that exposure to sunlight, especially ultraviolet (UVB) rays (the most active type of ultraviolet radiation that is harmful to the conjunctiva), is the main risk factor associated with the development of pterygium, but other elements increase the likelihood of its appearance.
“Outdoor work or sports, dry environments, dust and wind, chronic dry eyes, genetic predisposition and recurrent inflammatory processes on the surface of the eye increase the chance of the condition occurring. This is why pterygium is more common in tropical and equatorial regions,” reveals the specialist.
According to Dr. Guy Romaguera Cantu, the most common symptoms that may indicate the appearance of pterygium are persistent redness, the sensation of sand or a foreign body, burning, irritation, and dry eyes. “In addition, there may be a gradual increase in ‘bulk’ toward the cornea. The patient may also experience mild photophobia and, in advanced cases, corneal distortion and worsening vision.”
The professional adds that the condition becomes worrying when it affects the cornea and begins to obscure the axis of vision, distorting the curvature of the cornea, which generates astigmatism, or grows rapidly, causes chronic inflammation or causes severe discomfort that does not improve with eye drops. “When it reaches the center of vision, surgery becomes mandatory,” he says.
Treatment for pterygium varies depending on its severity and symptoms. In the early stages and with mild symptoms, clinical treatment is indicated, while surgery is necessary when there is progressive growth of the cornea, induced astigmatism, chronic irritation, related aesthetic problems or risk of affecting vision.
“Non-surgical treatment includes lubricants, short-term topical corticosteroids, anti-inflammatories, control of dry eyes, and glasses with UV protection. The most modern surgical technique includes excision with conjunctival culture and the use of biological glue, which reduces pain, recovery time and chances of recurrence,” explains Dr. Guy Romaguera Cantu.
Without adequate monitoring, pterygium can develop into complications such as progressive astigmatism, recurrent inflammation, and permanent distortion of the cornea. There may also be decreased vision, visual axis progression and relapses — the reappearance of the pterygium after treatment — which are more aggressive when surgery is performed late.
Dr. Guy Romaguera Cantu confirms that preventive measures are effective in reducing the risk of developing the condition. He highlights the use of sunglasses with UV protection, a hat or wide brim, and eye lubricants to control dry eyes, in addition to avoiding high winds, dust and smoke, taking breaks from visually stressful tasks and maintaining regular eye monitoring.
“Pterygium is a common disease in hot and sunny regions such as Brazil, but it is completely treatable. The earlier it is diagnosed, the easier it is to manage. When surgery is indicated, current techniques allow excellent results, both functional and aesthetic – with a very low recurrence rate,” the ophthalmologist concludes.