Pterygium (surfer's eye): treatment, causes, symptoms and surgery

Guy's and St Thomas' says treatment depends on your symptoms. If the pterygium is small or growing you might be prescribed eye drops or ointments to help with redness or irritation. Hull University Teaching Hospitals adds that lubricating drops or anti-inflammatory medications may help mild symptoms but do not remove the pterygium.

Guy's and St Thomas' says that surgery is the only way to remove a pterygium. You might be advised to have surgery if it is causing constant eye irritation, causing problems with your sight or you are unhappy with how it affects your appearance. Hull says surgery is usually advised if the pterygium is growing over the central cornea and affecting your vision, or causes persistent discomfort that cannot be relieved with artificial tears or lubricants.

Many people never need an operation. Guy's and St Thomas' says it is unlikely that a pterygium will get worse if you are living in the UK, but it could get worse if you move to a hotter, drier climate.

Hull University Teaching Hospitals explains that the pterygium is removed from the cornea and sclera, and a graft of your own conjunctiva, usually taken from under the upper eyelid, is secured with tissue adhesive. The graft reduces the risk of recurrence and helps restore a smoother corneal surface. A soft contact lens is placed for comfort while the cornea heals, and the procedure typically lasts around 45 minutes.

Hull says the anaesthetic may be local, with you awake and the eye numbed with drops or an injection, or general, usually for more complex or recurrent cases. Afterwards an eye pad is placed overnight.

Recovery: it is normal to have soreness, scratchiness or a gritty sensation for 1 to 2 weeks, redness and mild discomfort can persist for several weeks, and full healing can take up to three months. You will be prescribed antibiotic drops for two weeks, with steroid and lubricating drops for up to three months. You may need 1 to 2 weeks off work, and should check with your doctor before driving again. Avoid rubbing the eye, dusty or dirty environments and swimming until cleared by your doctor.

Hull lists the risks as recurrence, infection, bleeding, scarring (a faint corneal scar, usually with minimal visual effect) and, rarely, loss of vision. It describes the procedure as generally safe.

The conjunctiva is the thin layer that covers the white of the eye. Hull describes a pterygium (pronounced tur-IJ-ee-um) as a benign growth of the conjunctiva that extends onto the cornea, the clear window at the front of the eye. Guy's and St Thomas' says it can grow large enough to affect vision.

It is often called surfer's eye because of its link with sun and wind exposure, but it can affect anyone with long exposure to bright light, wind and dust.

Guy's and St Thomas' says a pterygium usually develops if you have been living in a hot, dry climate. This might be a response to your eye's long-term exposure to sunlight, or chronic eye irritation from the dry climate.

The sources read do not give formal prevention advice. Wearing sunglasses that block ultraviolet light and a brimmed hat in bright conditions is a common-sense precaution if you spend a lot of time outdoors in sunny, dry or windy places.

Guy's and St Thomas' lists irritation, redness and tearing (eyes watering) as symptoms. Hull adds that a pterygium may cause redness, irritation, dryness or a gritty sensation.

As it develops it can change the shape of the cornea, making it curve more. Guy's and St Thomas' says this causes astigmatism, which affects how the eye focuses, and when the pterygium has grown towards the centre of the cornea it will affect vision. Hull says it can change your glasses prescription or block vision if it grows over the central part of the cornea.

Guy's and St Thomas' says the ophthalmologist (eye doctor) will be able to see the pterygium just by looking at your eye, so no special test is needed. The examination will also show how far it has spread across the cornea and whether it is affecting your vision. An optometrist or GP may spot it first and refer you.

A pterygium itself is not an emergency, but a red eye can have serious causes. NICE CKS lists red flag features that may indicate a serious or potentially sight-threatening cause of red eye, including reduced visual acuity, moderate to severe pain, headache and photophobia (sensitivity to light). If you have a painful red eye, loss of vision or light sensitivity, get urgent assessment from an optometrist, urgent eye service, NHS 111 or A&E.

After surgery, Hull says to seek immediate medical advice if you notice increasing pain, redness or swelling in the eye, worsening or blurred vision, or sensitivity to light. It lists infection and, rarely, corneal ulceration as complications.

The usual NHS route is through an optometrist or GP to a hospital eye service, where an ophthalmologist confirms the diagnosis and discusses surgery if needed. Availability and waiting times for surgery vary between areas, and some NHS areas restrict procedures that are done mainly for appearance, so ask your GP or optometrist how local referral works.

Private ophthalmologists can also assess and operate. The decision about when to operate is made in the same way, so ask about recurrence rates in the surgeon's own practice, the technique and graft used and what follow-up is included.