Pterygium: Causes, Symptoms, and Treatment
What Is a Pterygium?
A pterygium is a fleshy overgrowth of tissue that develops on the conjunctiva, the thin clear membrane covering the white part of the eye. Understanding what it looks like and who tends to develop it can help you recognize it early and seek the right care.
A pterygium typically appears as a pink, wedge-shaped piece of tissue that begins near the inner corner of the eye, closest to the nose. It grows from the conjunctiva and can extend onto the cornea, the clear dome-shaped surface at the front of the eye. In some cases it may also appear at the outer corner of the eye. The growth is usually raised and may contain small visible blood vessels, giving it a reddish appearance.
Pterygium is more common in adults over 40, and it tends to affect men more than women, particularly those who spend significant time outdoors. People who live or work in sunny, dry, dusty, or windy environments carry a higher risk. Outdoor activities such as farming, fishing, and surfing that involve regular exposure to UV light and environmental irritants are associated with a greater likelihood of developing this growth.
What Causes Pterygium?
The exact cause of pterygium is not fully understood, but long-term exposure to certain environmental factors is strongly linked to its development. Knowing these risk factors can help you take practical steps to protect your eyes.
Prolonged exposure to ultraviolet (UV) rays from the sun is considered the primary environmental trigger for pterygium. UV light can damage the cells on the eye's surface over time, eventually stimulating abnormal tissue growth. This is why pterygium is far more common in regions closer to the equator, where sunlight is intense year-round. Wearing sunglasses with UV protection is one of the most effective preventive measures you can take.
Chronic irritation from dust, sand, smoke, and wind can also contribute to pterygium development over time. People who work in construction, agriculture, or other outdoor industries, as well as those who live in arid climates, face increased exposure to these irritants. Using lubricating eye drops and wearing protective eyewear in harsh conditions can help reduce day-to-day irritation.
Pterygium tends to become more common with age, and there may be a genetic component, as it sometimes runs in families. While no single gene has been identified as the cause, a personal or family history of pterygium is worth mentioning to your eye care provider, especially if you spend a lot of time outdoors.
Recognizing the Symptoms
Symptoms can range from mild and occasional to persistent and disruptive, depending on the size and activity of the growth. Recognizing what to watch for helps you seek care before the condition progresses.
Many people first notice redness, itching, or a mild burning sensation in the affected eye. A frequent complaint is the feeling that something is stuck in the eye, even when nothing is there. These early symptoms may come and go, and they are often more noticeable in dry weather, windy conditions, or after extended time outdoors.
If the pterygium grows far enough onto the cornea, it can distort the shape of the eye's surface and cause astigmatism, a condition in which the cornea is unevenly curved, making vision blurry or distorted. In more advanced cases, a large pterygium may partially cover the pupil and reduce overall visual clarity. Vision changes of any kind are a strong reason to schedule an evaluation promptly.
Persistent redness or irritation that does not improve with over-the-counter lubricating drops, worsening discomfort, or any noticeable change in your vision are all signs that you should be seen by a Cornea Specialist. Thick or inflamed pterygia can also make wearing contact lenses uncomfortable or impossible. You do not need to wait for the growth to become large before seeking an evaluation.
How Is Pterygium Diagnosed?
Diagnosing a pterygium is typically straightforward and does not require any invasive testing. A thorough eye examination provides all the information needed to confirm the condition and plan appropriate care.
Your Cornea Specialist will examine the eye using a slit lamp, a specialized microscope that illuminates and magnifies the eye's surface in detail. This allows the provider to assess the size, shape, and extent of the growth, including how much of the cornea may be involved. The exam is quick and painless, and no special preparation is required.
A pterygium can sometimes be confused with a pinguecula, a similar but distinct growth that remains on the white part of the eye and does not extend onto the cornea. In rare cases, the appearance may warrant additional evaluation to rule out other conditions, including benign tumors of the eye's surface. If there is any uncertainty, photographs of the growth or a small tissue sample may be taken. Regular follow-up visits allow your care team to monitor any changes over time.
Treatment Options for Pterygium
Treatment is guided by the severity of your symptoms and how much the growth is affecting your daily life and vision. Options range from simple at-home comfort measures to surgical removal when needed.
When a pterygium is small and not affecting vision, the goal of treatment is to control irritation and slow any potential progression. Lubricating eye drops, often called artificial tears, can relieve dryness and reduce the sensation of a foreign body in the eye. Short-term use of anti-inflammatory or mild steroid eye drops may be recommended during flare-ups to reduce redness and swelling. These treatments manage symptoms but do not remove the growth.
Surgical removal is recommended when a pterygium is causing vision problems, persistent pain, or significant cosmetic concern, or when it has grown large enough that it can no longer be managed comfortably with drops alone. Our Cornea Specialists, including Dr. Jane Cook and Dr. Christopher Newton, perform pterygium excision using a conjunctival autograft technique. This approach takes a small piece of healthy tissue from another part of the eye's surface and uses it to cover the area where the pterygium was removed. This grafting technique significantly reduces the likelihood of the pterygium returning, with recurrence rates generally below 10 percent when graft techniques are used.
Recovery after pterygium surgery is usually manageable, and most patients return to normal activities within a short period of time. You can expect some redness and mild discomfort in the days following surgery, and your provider will prescribe eye drops to support healing and prevent inflammation. Follow-up appointments allow your care team to confirm proper healing and monitor for any signs of recurrence. Continuing to protect your eyes from UV light and environmental irritants after surgery is an important part of maintaining long-term results.
How to Help Prevent Pterygium
While pterygium cannot always be prevented, particularly if you have a family history or work outdoors regularly, consistent protective habits can meaningfully reduce your risk and slow the progression of an existing growth.
Wearing wraparound sunglasses with full UV-A and UV-B protection is the single most effective daily habit for reducing UV exposure to the eye's surface. Adding a wide-brimmed hat on sunny days provides additional protection from overhead and angled sunlight. This is especially important during midday hours when UV intensity is highest, and when spending time near water, sand, or snow, which can reflect and amplify UV rays.
Using lubricating eye drops regularly if you work in a dry, dusty, or air-conditioned environment helps maintain a healthy tear film and reduces surface irritation. Avoiding rubbing your eyes when outdoors in dusty conditions is also a simple but helpful habit. If you wear contact lenses and have a known pterygium, discussing lens type and fit with your eye care provider can help prevent additional irritation. These steps benefit overall eye health in addition to reducing pterygium risk.
Frequently Asked Questions
The following answers address common questions patients have after learning about pterygium, with practical guidance to help you make informed decisions about your eye health.
A pterygium does not resolve on its own. Without treatment, it may remain stable for years or grow slowly over time. Lubricating drops can ease symptoms, but they will not cause the tissue to shrink or disappear. If the growth begins to affect your vision or becomes consistently uncomfortable, a consultation with a Cornea Specialist is the appropriate next step to discuss whether removal is warranted.
A pinguecula is a small, yellowish raised bump that forms on the conjunctiva but stays within the white part of the eye and does not extend onto the cornea. A pterygium, by contrast, grows across the limbus (the border between the white and clear parts of the eye) and onto the cornea itself. A pinguecula can sometimes develop into a pterygium over time, which is one reason monitoring a pinguecula with routine eye exams is worthwhile.
Yes, as a pterygium grows onto the cornea, the tissue can pull on or physically distort the corneal surface, creating or worsening astigmatism. Astigmatism from a pterygium causes objects to appear blurry or slightly distorted at multiple distances. In some cases, this cornea-induced astigmatism can be partially reversed after the pterygium is surgically removed and the cornea is allowed to return to a more natural shape.
Many people with small, stable pterygia continue wearing contact lenses comfortably. However, a larger or inflamed pterygium can make lens wear difficult due to irritation, poor lens fit, or irregular corneal surface changes. Switching to glasses during flare-ups, trying a different lens type, or increasing lubrication may help. If contact lens wear is becoming increasingly uncomfortable, your eye care provider can assess whether the growth has progressed to a point where other options should be considered.
Recurrence is possible after pterygium removal, though using a conjunctival autograft significantly reduces the risk. If a pterygium does return after surgery, it is often smaller and may be managed more conservatively than the original growth. In cases of true recurrence that affects vision or comfort, repeat surgery may be discussed. Consistent use of UV-protective eyewear and lubricating drops after any pterygium procedure is one of the best ways to reduce the chance of regrowth.
Yes, and the type of sunglasses matters. Wraparound or close-fitting frames with lenses rated for full UV-A and UV-B protection provide the most coverage by limiting light that enters from the sides as well as the front. Standard fashion sunglasses without UV ratings may reduce glare but do not adequately block harmful UV rays. For anyone spending regular time outdoors, especially in reflective environments like beaches or open water, quality UV-protective eyewear is a meaningful and evidence-supported preventive measure.
Expert Pterygium Care at Rhode Island Eye Institute
Our team of fellowship-trained Cornea Specialists at Rhode Island Eye Institute brings extensive experience in diagnosing and treating pterygium, from early monitoring through surgical removal with conjunctival grafting. We combine specialty surgical expertise with integrated optometric care so that every patient receives the right level of attention at every stage of their condition. If you have noticed a growth on your eye or are experiencing persistent redness and irritation, we encourage you to schedule a consultation and let us help you find lasting relief and clarity.