Pterygium: UK symptoms, treatment and surgery explained

A pterygium is a triangular, fleshy growth of conjunctiva that creeps onto the cornea, usually from the nasal side. Unlike a pinguecula, it can distort vision and, if it reaches the pupil, block sight altogether. Modern surgery with conjunctival autograft has dropped recurrence rates from over 50% to under 5%.

What causes a pterygium

Cumulative **UV exposure** is the main driver, which is why pterygia are common in patients who spent their earlier years in sunny climates. Dust, wind and dry environments also contribute. Genetics probably plays a role because it runs in families.

Symptoms

- A visible pink/red fleshy triangle extending from the white of the eye onto the cornea

- Grittiness, redness, watering

- Astigmatism — flattening of the cornea causing blurred vision

- Rarely: restriction of eye movement if the pterygium is very advanced

When surgery is offered

Excision is offered when a pterygium:

- Is close to the visual axis or causing measurable astigmatism

- Is inflamed repeatedly despite lubricants

- Is cosmetically distressing

- Is interfering with contact-lens wear

Small, quiet pterygia with no visual effect are watched.

Modern pterygium surgery

The gold-standard is **pterygium excision with conjunctival autograft**:

1. Local anaesthetic drops and injection

2. The pterygium is dissected off the cornea and sclera

3. A small graft of the patient's own conjunctiva (from under the upper lid) is placed over the bare sclera

4. The graft is fixed with fibrin glue or fine sutures

The procedure takes 30–40 minutes and is done as a day case.

Recovery

- Blurred, sore red eye for 3–5 days

- Steroid and antibiotic drops for 4–6 weeks

- Return to desk work at 1 week, sport at 4 weeks

- Final cosmetic result at 3–6 months

Recurrence — why the technique matters

Simple excision has a recurrence rate above 50%. With conjunctival autograft — sometimes combined with a short course of mitomycin — recurrence falls to under 5% in experienced hands. Do not accept 'bare sclera' excision.

NHS vs private

NHS pterygium surgery is available but with long waits. Private surgery typically costs £2,500–£3,500 per eye and can be done within weeks.

Book a consultant-led pterygium assessment

For a growing or symptomatic pterygium, book a consultation with my private practice or call **020 3137 3237**.