It is a slightly raised, triangular-shaped fibrovascular tissue in the front part of the eyeball, which starts from the sclera (white of the eye) and extends to the cornea (the clear front part of the eyeball). Usually, exposure to sunlight for several hours increases the risk of developing a flail (typically called surfer’s disease). The flails are benign, but despite this, in addition to the deformation they create, they can also cause vision loss when they extend towards the center of the cornea.
The exact cause of pterygium has not yet been determined. Pterygium occurs most frequently in people who spend most of their time outdoors, especially in warm climates with a lot of sunshine. Prolonged exposure to sunlight, especially ultraviolet radiation, as well as chronic irritation of the eye from dry environments and conditions of increased dust, seem to be a genesis cause. Although ultraviolet radiation from the sun appears to be the primary cause of the creation and development of pterygium, dust, air and dry eyes also seem to be involved in the development of pterygium.
They usually appear between the ages of 30-50 and even fair skin increases the risk of pterygium.
They usually appear on the nasal (towards the nose) side of the eyeball, but sometimes they can also appear on the temporal (outer) side. They can affect one or both eyes. In the early stages, there are usually no symptoms and no special treatment is needed. However, in cases where the flail is large, it can cause a foreign body sensation, itching or even a burning sensation. Sometimes they become inflamed and create intense redness in the affected eye. When a flail extends into the cornea, it can cause vision deviations and astigmatism.
It depends on its size, whether it is growing and the symptoms it causes. Regardless of their severity, all flails should be monitored by your ophthalmologist every 6 months-1 year. When a flail is small, instilling moisturizing drops or mild corticosteroid eye drops is sufficient to reduce inflammation and redness. Sometimes contact lenses are used to cover the flail and thus prevent further exposure to ultraviolet radiation. Cyclosporine can also be given topically for the eye with dry eye.
In the case where the flail causes severe symptoms, is constantly inflamed or interferes with vision, then surgical removal must be performed. There are several surgical techniques. Your ophthalmologist, who will operate on it, will decide which surgical technique is appropriate for your needs.
It is performed in a sterile operating room, under local anesthesia. It usually does not last more than 30 minutes- 1 hour (depending on the technique used). After the operation, the eye will need to be covered for 1-2 days. After the eye covering is removed, you can return to your daily activities.
Unfortunately, flaps can regrow after surgical removal, especially in young individuals. However, avoiding exposure to ultraviolet radiation by wearing sunglasses and using surgical removal techniques reduce the recurrence rate. It is preferable to surgically remove a flap during a period without much sunlight, and the use of an autograft to cover the area from which the pterygium was removed reduces the risk of recurrence. A drug that has been used locally to prevent recurrence is mitomycin C (MMC). Any of the above is the surgeon’s choice and is individualized depending on the flap.
Your doctor will give you corticosteroid drops for a few weeks to reduce swelling and recurrence. It is also necessary to wear protective sunglasses.