Pterygium

Pterygium is a triangular, wing-shaped piece of tissue that grows from the clear white part of the eye (the conjunctiva) onto the clear front window of the eye (the cornea). It most often starts on the side of the eye near the nose and slowly moves toward the center. The surface looks fleshy and pink because it contains many small blood vessels. This growth is not a cancer, but it can cause redness, irritation, and blurred vision if it changes the shape of the cornea or covers the pupil. The growth happens because the surface of the eye is repeatedly stressed, mainly by sunlight (ultraviolet light), dryness, dust, and wind. These stresses injure the edge of the cornea where special limbal stem cells normally protect and repair the surface. When these cells are damaged, the surface heals in an abnormal, scar-like way, and fibrovascular tissue slowly creeps onto the cornea. This is why pterygium is very common in hot, sunny, dry, and dusty climates and in people who work or spend a lot of time outdoors without eye protection.

A pterygium is a wedge-shaped growth of pink, fleshy tissue that starts on the clear white surface of the eye (the conjunctiva) and slowly creeps onto the cornea (the eye’s clear front window). It most often begins on the nasal side, looks like a small “wing,” and grows very slowly over months to years. Sunlight (especially UV), dusty or windy air, and dry, irritated eyes are common triggers. Many people only feel mild burning, itching, or a “gritty” sensation. Some develop redness, visible blood vessels, or astigmatism (warping of the cornea) that can blur vision. Surgery is usually considered when the growth threatens vision (approaches the pupil or distorts the cornea), causes frequent irritation that does not settle with medical care, restricts eye movement, or for significant cosmetic reasons. EyeWikiScienceDirect

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How pterygium forms

The eye surface is like a smooth, wet windshield that needs a healthy tear film and intact limbal stem cells to stay clear. Ultraviolet light from the sun creates tiny injuries in the eye surface over many years. Wind, dust, and dryness then make the surface more inflamed and rough. The body tries to repair this area, but when the limbal border is damaged, the repair switches to a scar-type healing pattern. Cells called fibroblasts and new blood vessels grow forward from the conjunctiva. This creates the wing-shaped fibrovascular tissue we see as a pterygium. Over time this tissue pulls on the cornea, changes its smooth curve, and may cause astigmatism or, if it reaches the center, may block the line of sight.

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Types of pterygium

1. Primary vs. Recurrent
   Primary pterygium is the first growth that appears. If it is removed with surgery, it can come back; when it returns, it is called recurrent pterygium. Recurrent pterygium often grows faster and thicker because the healing response after surgery can trigger more fibrovascular tissue to form.

2. Progressive (fleshy) vs. Stationary (atrophic)
   A progressive or fleshy pterygium looks thick, red, and vascular, with clear vessels that cross the cornea; it tends to move forward over time. A stationary or atrophic pterygium looks thin, pale, and flat, and usually stays quiet without much movement. Doctors use appearance to judge whether the growth is likely to progress.

3. Nasal vs. Temporal
   Most pterygia grow from the nasal side toward the center because sunlight reflects from the nose onto the inner eye, increasing UV exposure there. Temporal pterygia start from the outer side. Some people get both (bilateral).

4. Unilateral vs. Bilateral
   A pterygium can be in one eye (unilateral) or both eyes (bilateral). People with strong UV exposure and dry, dusty work often have bilateral disease.

5. Clinical size grades (by how far they reach onto the cornea)

• Grade 1: less than 2 mm onto the cornea.

• Grade 2: about 2–4 mm onto the cornea.

• Grade 3: more than 4 mm and approaching or touching the pupil.

• Grade 4: crosses the pupil and obstructs vision.
  These size grades help decide when treatment is needed, especially if astigmatism or visual axis blockage occurs.

6. True pterygium vs. Pseudopterygium
   A true pterygium grows from the limbus in a broad, fixed way and is firmly attached at the leading edge. A pseudopterygium looks similar but forms after local injury (like a burn or infection) and does not have a broad limbal base; it is loosely attached and can be lifted in places with a blunt probe during exam. This distinction matters because treatment and recurrence risk differ.

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Causes

1. Chronic ultraviolet (UV) light exposure
   UV light from the sun injures the surface cells and damages limbal stem cells. Repeated exposure stimulates abnormal healing, which builds scar-like fibrovascular tissue that forms a pterygium.

2. Dry, windy, and dusty environments
   Dry air and wind evaporate tears and roughen the surface, while dust causes tiny scratches. The eye responds with inflammation, which encourages growth of fibrovascular tissue onto the cornea.

3. Outdoor occupations
   Farmers, fishers, construction workers, lifeguards, and street vendors spend many hours in sun, wind, and dust. Without protection, the constant surface stress raises the pterygium risk.

4. Living near the equator or at high altitude
   Areas near the equator and high altitudes have stronger UV. People in these regions often develop pterygium at younger ages and with higher frequency.

5. Limbal stem cell stress or deficiency
   The edge of the cornea holds stem cells that keep the surface smooth. Long-term UV and dryness weaken this barrier. When it weakens, conjunctival tissue can cross the border and grow onto the cornea.

6. Chronic eye surface inflammation
   Allergic conjunctivitis, blepharitis, or long-standing irritants keep the eye red and inflamed. Inflammation releases growth signals and enzymes (like matrix metalloproteinases) that remodel tissue and allow the growth to advance.

7. Genetic susceptibility
   Some families and ethnic groups show higher rates, suggesting that inherited factors influence how the eye responds to UV and inflammation, making pterygium more likely.

8. Male sex and middle age
   Men with outdoor work often get higher lifetime UV exposure. Middle age is when cumulative exposure becomes large enough for the growth to appear and progress.

9. Low humidity and air pollution
   Low humidity dries the tear film, while pollution adds irritating particles and oxidative stress. Together they inflame the surface and drive growth.

10. Lack of UV-blocking eyewear
    Not wearing wraparound sunglasses or a hat with a brim lets direct and side-reflected UV reach the inner eye corner, which is the most common starting point.

11. Contact lens over-wear or poor fit (rare contributor)
    If a lens is too dry or poorly fitted, it can rub the surface and reduce oxygen, adding mechanical stress that may worsen irritation.

12. Workplace irritants (smoke, chemicals, sand)
    Industrial settings, welding arcs, and smoke injure and inflame the surface. Repeated minor injury feeds the cycle that allows the pterygium to grow.

13. Previous surface injury or burn (pseudopterygium link)
    A chemical or thermal burn can cause local scarring that looks like a pterygium (pseudopterygium). The healing pattern may mimic true pterygium growth.

14. Allergic eye disease
    Itching and eye rubbing mechanically stress the surface. Allergic inflammation thickens the conjunctiva and encourages vessel growth, increasing pterygium risk.

15. Chronic dry eye
    A poor tear film leaves the cornea unprotected. Friction from blinking over a dry surface micro-injures the epithelium and invites inflammatory healing.

16. Geographic and occupational dust storms
    Frequent dust storms create repeated abrasion of the ocular surface. The body responds with fibrovascular repair, feeding the forward growth.

17. Skin and tissue aging (elastotic degeneration)
    With age and sun exposure, the conjunctival tissue develops elastotic changes (degeneration of elastic fibers). This aged, sun-damaged tissue is more likely to creep onto the cornea.

18. Poor eye protection in sports
    Surfing, sailing, beach volleyball, skiing, and cycling expose eyes to reflected UV, wind, and spray. Without wraparound protection, the inner eye corner receives high dose UV.

19. Smoking (possible contributor)
    Smoke adds oxidative stress and eye surface irritation. This worsens inflammation and may accelerate growth in people already at risk.

20. Systemic autoimmune dryness (e.g., Sjögren’s)
    Reduced tears leave the surface unlubricated and inflamed. Chronic dryness magnifies UV damage and promotes scar-type repair, helping the pterygium advance.

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Symptoms

1. Visible pink or fleshy growth
   People often notice a triangular, pinkish patch growing from the inner corner toward the colored part of the eye. The appearance can be cosmetically distressing.

2. Redness and visible blood vessels
   The growth has many small vessels, and the surrounding tissue becomes inflamed, making the eye look constantly red.

3. Foreign-body or gritty sensation
   The surface becomes uneven and dry, so blinking feels like there is sand in the eye, especially in windy or air-conditioned places.

4. Burning or stinging
   Inflamed surface nerves send pain signals, and evaporative dryness causes a stinging feeling that comes and goes.

5. Itching
   Mild allergic-type itching often occurs because the surface is inflamed, and people may rub the eye, which can worsen irritation.

6. Tearing (watery eyes)
   The eye sometimes over-tears to compensate for dryness or irritation, so people feel wetness even though the eye surface is functionally dry.

7. Light sensitivity (photophobia)
   A rough, inflamed surface scatters light, and exposure to bright sunlight or strong indoor lights can bother the eye.

8. Blurry vision
   If the growth changes the shape of the cornea or reaches the pupil, vision becomes blurry, especially for distance or night driving.

9. Astigmatism-related distortion
   By pulling on the cornea, a pterygium can create or increase astigmatism, which causes ghosting, shadowing, or stretched images.

10. Eye fatigue
    Extra effort to focus through astigmatism and deal with glare makes the eyes tire easily, especially after reading or screen time.

11. Recurrent inflammation or episodes of “flare-ups”
    People describe periods where the growth becomes red, swollen, and tender. These are inflammatory flares often triggered by sun, wind, or dust.

12. Dryness worse at day’s end
    Tears evaporate through the day, so evening dryness is common, with more grittiness and blur later in the day.

13. Contact lens intolerance
    The uneven surface and extra vessels make contact lenses less comfortable. Some cannot wear lenses for long periods.

14. Pulling or tightness toward the nose
    A larger pterygium can tether the conjunctiva, creating a pulling feeling with eye movement.

15. Glare and halos at night
    A rough corneal surface scatters headlights, creating glare and halos, which may reduce night driving comfort.

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Diagnostic tests

A) Physical exam

1. Visual acuity (Snellen chart)
   You read letters at a standard distance. This measures how clearly you see. A drop in acuity suggests the pterygium is affecting the cornea or line of sight.

2. Pinhole test
   Looking through a small pinhole reduces the blur from astigmatism or surface irregularities. If vision improves with pinhole, the blur is likely optical, not from inside the eye.

3. External inspection with oblique light
   The doctor looks at the eye under good light, checking the shape, color, and blood vessels of the growth, and how far it extends onto the cornea.

4. Slit-lamp biomicroscopy
   A microscope with a bright, thin beam shows the growth in detail, including the head (apex), the body, and the base at the limbus. It helps judge activity, thickness, and risk of progression.

5. Pupil and light reflex check
   Basic pupil tests ensure the nerve pathway from eye to brain works properly. While usually normal in pterygium, it helps rule out other causes of blur.

6. Ocular alignment and Hirschberg light reflex
   A quick check of eye alignment confirms there is no strabismus or major misalignment contributing to visual symptoms or double vision complaints.

B) Manual tests

7. Refraction and keratometry
   Refraction finds your glasses prescription, and keratometry measures the curvature of the cornea. These tests show whether the pterygium has caused astigmatism or irregular curvature.

8. Fluorescein staining of the surface
   A safe yellow dye highlights dry spots and tiny defects on the cornea. Under a blue light, the doctor sees where the tear film breaks or the surface is damaged near the pterygium.

9. Tear film break-up time (TBUT)
   After dye is placed, the doctor times how quickly the tears break into dry spots. A short TBUT means evaporative dry eye, which often accompanies pterygium.

10. Schirmer test (tear production)
    A small paper strip is placed under the lower lid for a few minutes to measure tear volume. Low wetting suggests reduced tear production, which worsens irritation.

C) Lab and pathological tests

11. Impression cytology (surface cell sampling)
    A tiny filter paper briefly touches the surface to collect cells. Under the microscope, doctors look for conjunctivalization and goblet cells on the cornea, which show surface change due to pterygium.

12. Histopathology of excised tissue
    If surgery is done, the removed tissue is examined. Typical findings include elastotic degeneration, fibrovascular tissue, and inflammation. This confirms the diagnosis and rules out rare mimics.

13. Point-of-care MMP-9 test (tear inflammation marker)
    A quick in-office test can detect elevated MMP-9, an enzyme linked to surface inflammation. A positive result supports inflammatory dry eye alongside the pterygium.

14. Tear osmolarity
    This measures how concentrated the tears are. High osmolarity means unstable, dry tears, which worsen surface stress and symptoms.

15. Microbiology (when infection suspected)
    If the surface looks ulcerated, very inflamed, or infected, a swab for culture helps choose the right antibiotic. Infection is not typical, but it can occur with surface breakdown.

D) Electrodiagnostic tests

16. Visual evoked potential (VEP)
    Small sensors on the scalp measure the brain’s response to visual stimuli. It is rarely required in pterygium, but it can help confirm neural visual function if vision seems worse than expected from the surface growth alone.

17. Electroretinography (ERG)
    ERG measures the retina’s electrical response to light. It is almost never needed for a simple pterygium, but in complex cases it rules out retinal disease as a cause of blur.

E) Imaging tests

18. Anterior segment optical coherence tomography (AS-OCT)
    AS-OCT uses light waves to create cross-section images of the cornea and pterygium. It shows how deep the growth has gone and whether it distorts the corneal layers. This helps plan treatment and track progression.

19. Corneal topography or tomography (e.g., Scheimpflug/Pentacam)
    These tests map the shape and power of the cornea in detail. They reveal regular and irregular astigmatism caused by the pterygium’s pull, and they help decide if surgery might improve vision.

20. Ultrasound biomicroscopy (UBM)
    UBM uses high-frequency ultrasound to image the front eye layers. It can show thickness, extension, and any deeper involvement when the surface is hard to evaluate or when recurrent disease is suspected.

Non-pharmacological treatments

These measures are safe, practical, and work alongside any drops or surgery.

1. UV-blocking sunglasses (UV400)

   • Description: Wear wrap-around sunglasses outdoors, even on cloudy days.

   • Purpose: Cut UV exposure—the main environmental driver.

   • Mechanism: Blocks UVA/UVB reaching the limbus, reducing oxidative/inflammatory signaling that fuels growth and flare-ups. ScienceDirect

2. Wide-brim hat (≥7.5 cm brim)

   • Description: Use a brimmed hat whenever you’re outside.

   • Purpose/Mechanism: Adds shade and lowers stray light and wind hitting the ocular surface; complements sunglasses. ScienceDirect

3. Wind and dust protection

   • Description: Use side-shield or wrap-around glasses; avoid direct fan/AC airflow.

   • Purpose: Reduce mechanical and particulate irritation that worsens redness and growth activity.

   • Mechanism: Lowers microtrauma and tear film evaporation. ScienceDirect

4. Humidify and hydrate

   • Description: Room humidifier, avoid smoke, drink water regularly.

   • Purpose/Mechanism: Improves tear film stability and comfort on a dry ocular surface (a frequent co-traveler with pterygium). ScienceDirect

5. Blink breaks (20-20-20 rule)

   • Description: Every 20 minutes, look 20 feet away for 20 seconds and blink fully.

   • Purpose/Mechanism: Reduces evaporative stress from prolonged screens and improves tear spread.

6. Cold compresses

   • Description: Clean, cold compress over closed lids for 5–10 minutes during flares.

   • Purpose/Mechanism: Temporarily calms vasodilation and surface inflammation to relieve burning and redness.

7. Lid hygiene + warm compress for meibomian glands

   • Description: Warm compress (5–10 minutes) and gentle lid massage once daily.

   • Purpose/Mechanism: Improves the oil layer of tears, reducing evaporation and friction on the pterygium edge.

8. Allergen avoidance

   • Description: Keep windows closed in high-pollen, use HEPA filters, rinse lids/lashes after outdoor exposure.

   • Purpose/Mechanism: Lowers histamine-driven itching/rubbing cycles that inflame the ocular surface.

9. Hands-off policy (no rubbing)

   • Description: Avoid rubbing or poking the eye.

   • Purpose/Mechanism: Prevents micro-injury that perpetuates inflammation around the limbus.

10. Protective eyewear at work

    • Description: Use safety glasses for construction, farming, or windy/industrial settings.

    • Purpose/Mechanism: Limits particles and UV flashes, reducing triggers. ScienceDirect

11. Saline eyewash (sterile) after exposure

    • Description: Rinse with preservative-free sterile saline after beach, desert, or dusty work.

    • Purpose/Mechanism: Physically removes irritants that cling to the conjunctiva.

12. Environmental planning

    • Description: Schedule outdoor tasks away from peak-UV hours (10 a.m.–4 p.m.); seek shade.

    • Purpose/Mechanism: Lowers cumulative UV dose. ScienceDirect

13. Quit smoking / avoid secondhand smoke

    • Description: Eliminate smoke exposure.

    • Purpose/Mechanism: Smoke aggravates surface inflammation and destabilizes tears.

14. Contact lens caution

    • Description: Avoid cosmetic or poorly fitting lenses during irritation; only use medically indicated bandage lenses under clinician supervision (e.g., for adjacent corneal dellen).

    • Purpose/Mechanism: Prevents friction; when medically used, a bandage lens can shield the cornea and promote re-epithelialization. EyeWikiAAO

15. Artificial shade at work (visors, shields)

    • Description: For outdoor workers, install visors/shields.

    • Purpose/Mechanism: Practical UV and wind reduction.

16. Tear-friendly workplace

    • Description: Point fans away, reduce dust sources, and place screens below eye level.

    • Purpose/Mechanism: Minimizes evaporation and exposure.

17. Post-op eye shield adherence (after surgery)

    • Description: Wear the given eye shield when sleeping for the first week after surgery.

    • Purpose/Mechanism: Prevents accidental rubbing and graft displacement. EyeWiki

18. Adhere to follow-ups

    • Description: Keep review visits to monitor growth, corneal shape, and signs of recurrence.

    • Purpose/Mechanism: Early intervention improves outcomes. EyeWiki

19. UV-blocking, wrap design for children/young adults in high-sun regions

    • Description: Early, consistent sun protection in younger people living near the equator.

    • Purpose/Mechanism: High lifetime UV reduces risk and severity over decades. ScienceDirect

20. Manage dry-eye comorbidities

    • Description: Address blepharitis and meibomian gland dysfunction.

    • Purpose/Mechanism: A stable tear film reduces irritation that “activates” the pterygium edge. ScienceDirect

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Drug treatments

Important safety note: doses below are typical adult regimens or label-based examples for related ocular surface conditions. Your clinician will tailor duration and taper; steroid/NSAID use must be monitored for pressure rise, delayed healing, or rare corneal complications.

1. Lubricating eye drops (artificial tears; non-medicated, preservative-free preferred)

   • Class: Ocular lubricants (CMC, HA, HP-Guar, etc.).

   • Dose/Time: 1 drop up to QID–PRN (more often if preservative-free).

   • Purpose: Relieve burning, foreign-body sensation, reduce friction on the growth edge.

   • Mechanism: Stabilize tear film, dilute inflammatory mediators.

   • Side effects: Transient blur/sting; avoid chronic benzalkonium chloride exposure if frequent use. (General AAO guidance.) ScienceDirect

2. Mast-cell stabilizer/antihistamine (Olopatadine)

   • Class: Dual-action anti-allergy.

   • Dose/Time: 0.1% BID, or 0.2% once daily per labeling.

   • Purpose: Control itch/redness that triggers rubbing and irritation.

   • Mechanism: H1 blockade + mast-cell stabilization.

   • Side effects: Mild sting, dryness. DailyMed

3. Topical NSAID (Ketorolac 0.5%)

   • Class: Non-steroidal anti-inflammatory.

   • Dose/Time: QID for short courses during flares or post-op as directed.

   • Purpose: Pain and inflammation relief when steroids are avoided.

   • Mechanism: COX inhibition, lowers prostaglandins.

   • Side effects: Rare corneal epithelial issues with prolonged/unsupervised use; stinging. FDA Access Data

4. Topical corticosteroid (Loteprednol 0.5% or 0.2%; Fluorometholone 0.1%)

   • Class: Soft steroid (loteprednol) or steroid (FML).

   • Dose/Time: Typical QID, then taper over 1–2 weeks in flares; post-op per surgeon.

   • Purpose: Calm significant inflammation/redness or post-op inflammation.

   • Mechanism: Broad anti-inflammatory gene modulation.

   • Side effects: IOP rise, cataract with chronic use, infection risk—must be supervised. Bausch + LombDailyMed

5. Topical cyclosporine A 0.05% (Restasis)

   • Class: Calcineurin inhibitor (immunomodulator).

   • Dose/Time: 1 drop BID (about 12 hours apart).

   • Purpose: Treat chronic surface inflammation/dry eye that worsens pterygium symptoms; some studies examined post-op recurrence with mixed results.

   • Mechanism: T-cell modulation; increases basal tear production over weeks.

   • Side effects: Transient burning; rare infection risk. FDA Access DataPMC

6. Topical tacrolimus (compounded 0.03% ointment or drops) — off-label

   • Class: Calcineurin inhibitor.

   • Dose/Time: Commonly nightly or BID short courses for ocular surface inflammation (off-label; discuss with your specialist).

   • Purpose: Alternative to steroids for allergic/immune ocular surface disease that aggravates symptoms.

   • Mechanism: Calcineurin inhibition reduces T-cell cytokines.

   • Side effects: Burn/sting on instillation; requires medical supervision. PMCPubMed

7. Post-operative antibiotic (e.g., Moxifloxacin 0.5%)

   • Class: Fluoroquinolone antibiotic.

   • Dose/Time: 1 drop TID for 7 days post-op (per label); your surgeon may adjust.

   • Purpose: Reduce infection risk after surgery.

   • Mechanism: Inhibits bacterial DNA gyrase/topoisomerase.

   • Side effects: Mild irritation; rare allergy. Novartis

8. Antimetabolite adjunct — Mitomycin-C (MMC)

   • Class: Alkylating/antifibrotic (used intra-op or limited post-op, not a home drop).

   • Dose/Time: Typical intra-op 0.02% applied for ~2–3 minutes, then irrigated (exact protocol varies).

   • Purpose: Reduce recurrence by limiting fibroblast proliferation.

   • Mechanism: Inhibits DNA synthesis in subconjunctival fibroblasts.

   • Side effects: If misused—scleral melt, delayed epithelialization—specialist-only. PMC

9. Antimetabolite adjunct — 5-Fluorouracil (5-FU)

   • Class: Pyrimidine analog antifibrotic (surgeon-administered).

   • Dose/Time: Small subconjunctival injections intra-/post-op per protocol.

   • Purpose/Mechanism: Similar to MMC—reduces fibroblast-driven recurrence.

   • Side effects: Local irritation; rare toxicity (specialist-only). PMC

10. Anti-VEGF adjunct — Bevacizumab (off-label)

• Class: Anti-VEGF monoclonal antibody.

• Dose/Time: Subconjunctival ~2.5 mg (0.1 mL) around the head of the pterygium in studies, pre-/post-op or for recurrent vascularity.

• Purpose: Temporarily reduces vascularity and may reduce recurrence when paired with surgery; evidence is mixed.

• Mechanism: VEGF blockade decreases neovascular drive.

• Side effects: Local irritation, rare allergy; specialist-only. PMC

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Dietary “molecular” supplements

There is no supplement that shrinks a pterygium. Because UV-related oxidative stress and surface inflammation are involved, clinicians sometimes consider general ocular-surface–friendly nutrients. Evidence is indirect for pterygium specifically—discuss with your doctor, especially if you take blood thinners or have medical conditions.

1. Omega-3 (EPA+DHA) 1000–2000 mg/day — supports tear film lipid layer; anti-inflammatory eicosanoid shift.

2. Vitamin C 500–1000 mg/day — antioxidant cofactor for collagen turnover; theoretical support against oxidative stress.

3. Vitamin E 200–400 IU/day — lipid-phase antioxidant; may protect tear film lipids.

4. Lutein 10 mg + Zeaxanthin 2 mg/day — macular carotenoids; general ocular antioxidant support.

5. Zinc 8–11 mg/day — cofactor for antioxidant enzymes (SOD, catalase).

6. Selenium 55 mcg/day — glutathione peroxidase support.

7. Curcumin 500–1000 mg/day with pepper extract — systemic anti-inflammatory; GI caution.

8. N-acetylcysteine 600 mg 1–2×/day — glutathione precursor; mucolytic/antioxidant actions.

9. Vitamin D (per level; often 800–1000 IU/day) — immune-modulating; correct deficiency.

10. Blackcurrant/anthocyanins per label — antioxidant polyphenols; possible tear stability benefits.

(These are supportive for general ocular surface health; they don’t replace UV protection, lubricants, or surgery.)

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Regenerative / stem-cell–type” options

There are no approved “stem cell drugs” for pterygium. “Regenerative” care in this space means biologic eye drops or tissues that support healing and reduce inflammation—mainly used for severe ocular surface disease or after surgery, prescribed by specialists:

1. Autologous Serum Eye Drops (ASEDs, 20–50%)

   • Dose: Often QID (some use more frequently during acute healing).

   • Function/Mechanism: Patient’s serum contains growth factors (EGF, vitamin A, fibronectin) that promote epithelial healing and reduce symptoms. PMC

2. Platelet-Rich Plasma (PRP) tears

   • Dose: Commonly QID (protocols vary).

   • Function/Mechanism: Platelet-derived growth factors (PDGF, TGF-β) aid surface repair; used in severe dry eye/defects. PMC

3. Umbilical Cord Serum Drops (specialist/compassionate use)

   • Dose: Typically QID in studies (varies).

   • Function/Mechanism: Rich in epithelial trophic factors; immunomodulatory; investigational in many regions. Nature

4. Amniotic Membrane Extract Eye Drops (AME/AMEED) — investigational

   • Dose: Study protocols range from 6×/day for 30 days to QID (varies by trial).

   • Function/Mechanism: Soluble components of amniotic membrane reduce inflammation, support epithelial healing, and may inhibit corneal neovascularization. PubMedDove Medical Press

5. Topical Cyclosporine A 0.05% (immunomodulator)

   • Dose: BID.

   • Function/Mechanism: T-cell down-regulation improves chronic surface inflammation that aggravates symptoms; post-op recurrence data are mixed. FDA Access DataPMC

6. Topical Tacrolimus (0.03–0.1%; compounded) — off-label

   • Dose: Often nightly to BID short courses under supervision.

   • Function/Mechanism: Potent calcineurin inhibition for allergic/immune surface disease; steroid-sparing. PMC

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Surgeries

Surgery is the only way to remove a pterygium. The technique chosen affects comfort, healing, and—most importantly—recurrence risk.

1. Excision with Conjunctival Autograft (CAG) — current standard

   • Procedure: The growth is excised; a thin piece of your own conjunctiva (often with limbal tissue) is grafted over the bare area; fixed with fibrin glue or sutures.

   • Why: Lowest recurrence when done well; preserves ocular surface. Fibrin glue shortens surgery and reduces early discomfort vs sutures. PubMedEyeWiki

2. Limbal Conjunctival Autograft (LCAG) / P.E.R.F.E.C.T.

   • Procedure: Extends graft to include limbal stem-cell zone; the P.E.R.F.E.C.T. technique (extended removal + extended graft) is designed to drive recurrence very low in expert hands.

   • Why: Addresses stem-cell deficiency at the limbus; excellent cosmetic outcome and very low recurrence in specialized centers. PMC

3. Amniotic Membrane Transplant (AMT)

   • Procedure: After excision, a biologic amniotic membrane is sutured or glued over the area.

   • Why: Useful when conjunctiva must be spared (e.g., future glaucoma surgery). Recurrence is usually higher than CAG but can be acceptable when conjunctiva is limited. FDA Access Data

4. Adjunctive Antimetabolite (Mitomycin-C)

   • Procedure: Intra-operative sponge with MMC (e.g., 0.02% for ~2–3 minutes), then copious irrigation.

   • Why: Lowers recurrence in high-risk cases; requires experience to avoid rare but serious complications (scleral melt). PMC

5. Beta-irradiation (Strontium-90) — selected cases

   • Procedure: Low-dose beta radiation applied to the surgical site post-excision.

   • Why: Suppresses fibrovascular regrowth; now rare due to access and risk/benefit considerations. FDA Access Data

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Preventions

1. UV400 wrap-around sunglasses outdoors. 2) Wide-brim hat. 3) Avoid midday sun; seek shade. 4) Wind/dust protection at work. 5) Don’t rub your eyes. 6) Keep air humid and smoke-free. 7) Rinse with sterile saline after dusty exposure. 8) Manage allergies (environmental controls). 9) Treat dry eye/blepharitis to stabilize tears. 10) Keep scheduled eye checks if you already have a pterygium (watch for growth/astigmatism). ScienceDirect

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When to see a doctor

• Blurred or changing vision, new glare, or trouble focusing.

• Rapid growth toward the pupil or visible encroachment onto the cornea.

• Recurrent inflammation that doesn’t settle with lubricants/cold compresses.

• Eye movement restriction or double vision.

• After eye surgery or injury—especially new pain, discharge, or light sensitivity.

• Cosmetic concern that affects confidence or quality of life. EyeWiki

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What to eat” and “what to avoid

Food cannot remove a pterygium. The goal is a tear-friendly, anti-inflammatory pattern.

Eat more of:

1. Oily fish (salmon/sardine/mackerel) or plant omega-3 sources (chia/flax/walnut).

2. Dark leafy greens (spinach, kale) for lutein/zeaxanthin.

3. Colorful vegetables/berries (vitamin C & polyphenols).

4. Citrus/kiwi/guava (vitamin C).

5. Nuts/seeds (vitamin E, zinc).
   And: drink water regularly.

Limit/avoid:

1. Tobacco exposure.
2.  Heavy alcohol (dehydrates the ocular surface).
3. Ultra-processed, high-sugar foods (pro-inflammatory).
4. Very spicy/salty meals before long outdoor exposure (can worsen dehydration).
5. Poor sleep/irregular meals (stress/inflammation can worsen symptoms).

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Frequently asked questions

1. Will a pterygium go away on its own?
   No. It may stay small for years, but it does not melt away. Only surgery removes it. EyeWiki

2. Is it dangerous?
   It is benign. It becomes a problem if it blurs vision, causes astigmatism, or creates constant irritation. Rarely, similar-looking lesions can be tumors—your eye doctor can tell. EyeWiki

3. What makes it grow?
   UV light, wind, dust, and a dry/irritated ocular surface. Sun protection and reducing irritation help. ScienceDirect

4. When is surgery needed?
   If it nears the pupil, distorts the cornea, keeps inflaming despite care, restricts eye movement, or for significant cosmetic reasons. EyeWiki

5. What surgery has the lowest recurrence?
   Conjunctival (limbal) autograft, often with fibrin glue, shows low recurrence and faster comfort vs sutures in trials. PubMedEyeWiki

6. What is “recurrence”?
   Regrowth after removal. Technique and risk factors influence this; antimetabolite adjuncts (e.g., MMC) may be used in higher-risk cases. PMC

7. Do drops cure it?
   Drops calm symptoms and inflammation; they don’t erase the growth. Surgery is the definitive treatment. EyeWiki

8. Is mitomycin-C safe?
   It reduces recurrence but must be used by experienced surgeons because overdosing can damage tissue. PMC

9. Can anti-VEGF (bevacizumab) help?
   It can reduce blood vessels and may assist as an adjunct; results vary, and it’s off-label. PMC

10. What about amniotic membrane?
    AMT is helpful when conjunctiva must be spared, but recurrence is generally higher than with autograft. FDA Access Data

11. Will wearing sunglasses really help?
    Yes—consistent UV protection is one of the best preventive actions. ScienceDirect

12. Can children or young adults get it?
    Yes, especially in high-sun climates; early sun protection is important. ScienceDirect

13. Are there special contact lenses for this?
    Routine contacts aren’t a treatment. In selected cases with adjacent corneal dellen, doctors may use a bandage contact lens to protect healing tissue. EyeWikiAAO

14. What is fibrin glue?
    A biologic adhesive that secures the graft. It shortens surgery and early discomfort compared with sutures in RCTs. EyeWiki

15. Do cyclosporine or tacrolimus prevent recurrence?
    They help chronic surface inflammation. Evidence on recurrence after surgery is mixed for cyclosporine; tacrolimus is mainly used off-label for allergic/immune surface disease. PMC+1

Disclaimer: Each person’s journey is unique, treatment plan, life style, food habit, hormonal condition, immune system, chronic disease condition, geological location, weather and previous medical  history is also unique. So always seek the best advice from a qualified medical professional or health care provider before trying any treatments to ensure to find out the best plan for you. This guide is for general information and educational purposes only. Regular check-ups and awareness can help to manage and prevent complications associated with these diseases conditions. If you or someone are suffering from this disease condition bookmark this website or share with someone who might find it useful! Boost your knowledge and stay ahead in your health journey. We always try to ensure that the content is regularly updated to reflect the latest medical research and treatment options. Thank you for giving your valuable time to read the article.

The article is written by Team RxHarun and reviewed by the Rx Editorial Board Members

Last Updated: August 23, 2025.

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