What is Pterygium?
Have you noticed a fleshy, pinkish growth slowly spreading from the corner of your eye toward the coloured centre? That could be a pterygium, commonly called surfer’s eye. It is a non-cancerous growth on the eye’s surface that develops mainly because of long-term exposure to sunlight, dust, and dry wind.
Understanding Pterygium
When a pterygium grows onto the cornea, it can physically pull on it and distort its shape, causing astigmatism and blurred vision. If it grows further still, it can begin to cover the pupil and directly block vision.
Pterygium is extremely common in India. A review published in the Journal of Current Ophthalmology noted that pterygium prevalence is significantly higher in tropical and subtropical countries. India, with its combination of high UV intensity, large outdoor working population, and limited use of protective eyewear, has a high disease burden. Pterygium is more common in adults between 20 and 40 years of age and is seen more often in men, likely because of occupational outdoor exposure patterns in India.
What are the Pterygium Symptoms?
The pterygium symptoms can be so mild in the early stages that many people do not realise anything is growing on their eye. Some people have a pterygium for years without significant discomfort. Others develop pterygium symptoms that affect their daily comfort and vision considerably.
Pterygium Symptoms to Watch For
Symptom | What it feels like | |
🔴 | Redness and bloodshot appearance | The eye looks persistently red because of blood vessels in the pterygium |
😖 | Gritty or foreign body sensation | A feeling that something is in the eye even when nothing is there |
💧 | Watering or dry eyes | The pterygium disrupts the tear film, causing either excessive tearing or dryness |
🔥 | Itching or burning | Especially in dry or dusty conditions or after time outdoors |
🌫️ | Blurred vision | When the pterygium grows onto the cornea and distorts its shape |
💡 | Sensitivity to light | Inflammation in the pterygium makes bright light uncomfortable |
😮 | Visible growth | A fleshy, pinkish or whitish triangular tissue visible at the corner of the eye |
👓 | Contact lens discomfort | The growth alters the eye surface, making lens wear increasingly uncomfortable |
When Should You See a Doctor?
Please visit an eye specialist if:
- You notice a fleshy growth at the corner of one or both eyes
- The eye is persistently red and drops provide only brief relief
- Vision has become blurry or distorted in one eye
- Contact lens wear has become uncomfortable or impossible
- The pterygium appears to be growing larger or more inflamed
What are the Types of Pterygium?
Pterygium types are classified by the stage of growth and by whether it has occurred for the first time or returned after previous surgery. Understanding the types of pterygium helps the specialist decide whether pterygium treatment with eye drops is sufficient or whether pterygium surgery is needed.
The Four Stages of Pterygium
Stage | Where the pterygium has reached | Vision impact | Pterygium treatment recommendation |
Stage 1 | Conjunctiva only, not yet on the cornea | None | Lubricating drops, UV protection, monitoring |
Stage 2 | Just touching or on the corneal edge | Minimal | Eye drops; pterygium surgery considered |
Stage 3 | Growing across the cornea toward the pupil | Moderate blurring | Pterygium surgery recommended |
Stage 4 | Reaching or covering the pupil | Significant vision loss | Urgent pterygium surgery needed |
By Recurrence
Primary Pterygium: A first-time pterygium. Responds well to pterygium surgery with low recurrence rates when modern autograft techniques are used.
Recurrent Pterygium: A pterygium that has returned after previous pterygium surgery. More vascular, more aggressive, and more difficult to remove. Consistent UV protection after pterygium surgery is the most important factor in preventing recurrence.
Other Types
- Pseudopterygium: Not a true pterygium but a conjunctival fold stuck to the cornea following injury or inflammation. Managed differently from true pterygium.
- Double-headed pterygium: Growing from both inner and outer corners simultaneously, meeting on the cornea.
What Causes Pterygium?
The causes of pterygium are well established and strongly linked to environmental exposure. UV radiation from the sun is the single most important cause, and the combination of UV light with dust, dry air, and wind makes the risk substantially higher. Understanding the causes of pterygium explains why India has such a high prevalence and what can be done to reduce risk.
Primary Causes
UV radiation from the sun The dominant cause of pterygium. People who spend many hours outdoors under strong sunlight, year after year without protective eyewear, are at significantly higher risk. India’s tropical location means UV intensity is high throughout the year, making this an especially important pterygium cause in the Indian context.
Dust and dry environments Chronic exposure to dust, sand, and dry air causes repeated microtrauma to the eye surface. Combined with UV exposure, this creates the conditions for pterygium development. People working in construction, quarrying, and outdoor manual labour face elevated risk.
Wind and hot, dry weather Persistent wind dries out the eye surface and causes mechanical irritation to the conjunctiva over years. Combined with UV and dust, wind is a compounding factor in pterygium development.
Other Contributing Factors
- Advanced age, with cumulative lifetime UV exposure
- Male sex, due to occupational outdoor exposure in India
- Family predisposition (genetics)
- Living near the equator where UV is more intense year-round
- Vitamin A deficiency, which may contribute to conjunctival instability
How Do Doctors Diagnose Pterygium?
Pterygium is diagnosed visually during a slit lamp examination. The triangular growth, its visible blood vessels, and its position at the inner corner of the eye are characteristic. No blood tests or scans are needed for diagnosis, though additional measurements are taken to plan pterygium treatment and determine whether pterygium surgery is needed.
What the Doctor Assesses?
Assessment | What it determines |
Stage of the pterygium | How far onto the cornea the growth has advanced |
Corneal involvement | Whether and how much the cornea has been distorted |
Visual acuity | How much the pterygium has affected vision |
Corneal topography | Maps the corneal shape to detect astigmatism |
Activity of the pterygium | Whether actively growing (inflamed) or stable |
Differentiation from pseudopterygium | Rules out a similar-looking growth from injury |
What Does Pterygium Treatment Look Like?
Pterygium treatment depends on the stage of growth, how much discomfort it causes, and whether vision is affected. Pterygium treatment in the early stages focuses on symptom relief and slowing progression. When the pterygium has grown far enough to threaten vision or cause significant discomfort, pterygium surgery is the definitive pterygium treatment.
An important point for patients in India: there is no medicine that can dissolve or shrink an established pterygium. Pterygium treatment with eye drops can reduce redness and irritation, but it cannot reverse the growth. Pterygium surgery is needed for any pterygium that has advanced past the early stage.
Pterygium Treatment Options
- Lubricating Eye Drops (Artificial Tears): First-line pterygium treatment for mild cases
When pterygium is small and confined to the white of the eye, the main symptoms are dryness and mild irritation. Lubricating drops are the starting point for pterygium treatment in these early stages. They improve the tear film, wash away dust and irritants, and reduce discomfort. This pterygium treatment does not stop the pterygium from growing but manages day-to-day symptoms well. - Anti-inflammatory Eye Drops: For inflamed, red pterygium
When pterygium becomes more inflamed, short courses of mild anti-inflammatory drops such as steroid or non-steroidal eye drops may be prescribed as pterygium treatment. These reduce redness and swelling during active flares. Steroid drops should only be used under medical supervision, as long-term use carries risks. - UV-Protective Sunglasses: Prevention and slowing progression
Wearing good quality UV-protective sunglasses outdoors is one of the most important components of pterygium treatment and prevention. This measure also significantly reduces recurrence after pterygium surgery. Wraparound sunglasses provide better side coverage. - Pterygium Surgery: Excision with Conjunctival Autograft: Definitive pterygium treatment for advanced cases
When pterygium treatment with drops is no longer sufficient or when the pterygium has affected vision, pterygium surgery is recommended. The gold standard pterygium surgery is excision combined with a conjunctival autograft. - In this procedure, the pterygium is carefully removed. A small piece of healthy conjunctival tissue is taken from the upper part of the same eye and transplanted to cover the area where the pterygium was removed. This graft is secured with sutures or tissue adhesive. The graft significantly reduces recurrence compared to older techniques.
- Pterygium surgery is done under local anaesthesia as a day procedure, taking 20 to 40 minutes. Patients go home the same day and initial recovery takes one to two weeks.
- Pterygium Surgery: Amniotic Membrane Transplantation: For large or recurrent pterygium
When the pterygium is very large, has recurred after previous pterygium surgery, or when there is insufficient healthy conjunctiva for an autograft, amniotic membrane transplantation is used. Amniotic membrane has properties that reduce inflammation, scarring, and recurrence. - Mitomycin C (MMC) Application: To reduce recurrence in high-risk cases
Mitomycin C, a medicine that inhibits abnormal cell regrowth, may be applied during or after pterygium surgery to reduce the risk of recurrence. It is not used routinely but is a useful adjunct in cases at high risk, such as young patients or those with recurrent pterygium. - Postoperative Pterygium Treatment: After pterygium surgery
Following pterygium surgery, antibiotic and steroid eye drops are used for four to six weeks. Lubricating drops support healing. UV-protective eyewear must be worn consistently after pterygium surgery, as sun exposure is the main reason pterygium grows back.
Pterygium and Corneal Astigmatism: Understanding the Vision Impact
When a pterygium grows onto the corneal surface, it physically pulls on it, distorting its shape. This causes astigmatism, where vision is blurry at certain orientations. People with pterygium-induced astigmatism often find their spectacle number keeps changing as the pterygium grows. Following pterygium surgery, the tension the pterygium was applying to the cornea is released and the corneal shape gradually returns toward normal over the following weeks to months. This is why spectacle prescriptions are reassessed several weeks after pterygium surgery.
Pterygium vs Pinguecula: What Is the Difference?
| Feature | Pterygium | Pinguecula |
| Appearance | Fleshy, triangular, grows into cornea | Yellowish, dome-shaped, stays on white of eye |
| Location | Grows into cornea | Does not grow into cornea |
| Vision impact | Can affect vision | Does not affect vision |
| Pterygium treatment | Surgery when it affects vision | Lubricating drops; surgery not usually needed |
A pinguecula is another common eye surface condition frequently confused with pterygium in India. A pinguecula can sometimes develop into a pterygium over time, another reason why monitoring any growth on the eye surface is important.
Pterygium Prevention in India: Practical Steps
Wear UV-protective sunglasses outdoors
Choose those blocking 99 to 100% of UVA and UVB rays. Wraparound designs provide better side coverage.
Wear a hat or cap with a brim
Particularly useful for outdoor workers who find wearing sunglasses impractical all day.
Protect the eyes from dust and wind
Protective goggles during dusty work reduce mechanical irritation. Many Indian workplaces do not provide eye protection routinely.
Reduce outdoor exposure during peak UV hours
(10 am to 3 pm in India), especially when combined with dust and wind exposure.
Monitor existing pterygium regularly
Anyone with a pterygium should have it checked by an eye specialist at least annually to track whether it is growing.
What to Expect from Pterygium Surgery at Vasan Eye Care
Before pterygium surgery: Detailed slit lamp examination with corneal topography. Discussion of the technique, expected outcome, and pterygium surgery cost before any decision is made.
During pterygium surgery: Anaesthetic eye drops numb the eye. The pterygium is removed, a conjunctival graft is placed and secured with tissue adhesive or fine sutures. The procedure takes 20 to 45 minutes.
After pterygium surgery: Antibiotic and steroid eye drops for four to six weeks. UV sunglasses must be worn consistently outdoors to reduce recurrence. Follow-up at one week, one month, and three months.
Pterygium Care at Vasan Eye Care
At Vasan Eye Care, pterygium treatment and pterygium surgery are among the most commonly performed procedures at our eye surface and cornea clinics. Our pterygium surgery approach uses conjunctival autograft as standard, with amniotic membrane and adjunctive mitomycin C available for complex or recurrent cases.
When you come to us for pterygium treatment, you can expect a complete examination including corneal topography, honest guidance on whether drops are sufficient or pterygium surgery is needed, transparent information on pterygium surgery cost before any decision, pterygium surgery as a comfortable day procedure, and close post-operative follow-up.
Our 150+ centres across India, staffed by 500+ eye care specialists as part of ASG Enterprises, ensure pterygium treatment is accessible wherever you are.
Simple Guide to Pterygium Terms
| Word or phrase | What it means in simple terms |
| Pterygium | A fleshy triangular growth on the white of the eye that can grow onto the cornea |
| Surfer’s eye | The common name for pterygium |
| Conjunctiva | The clear tissue covering the white of the eye where pterygium begins |
| Cornea | The clear curved surface at the front of the eye |
| Pinguecula | Similar yellowish growth that stays on the white of the eye and does not grow onto the cornea |
| Conjunctival autograft | A piece of the patient’s own healthy conjunctiva used after pterygium removal |
| Amniotic membrane | A tissue graft used in complex pterygium surgery |
| Mitomycin C | A medicine applied during pterygium surgery to reduce recurrence |
| Recurrent pterygium | Pterygium that has grown back after previous pterygium surgery |
| Corneal topography | A scan mapping the cornea shape to detect pterygium-induced distortion |
RELATED EYE CONDITIONS
- Pinguecula
- Dry Eye Syndrome
- Corneal Astigmatism
- Conjunctivitis
- Corneal Scarring
REFERENCES
- Cleveland Clinic. Pterygium (Surfer’s Eye): Causes, Symptoms and Treatment. Last reviewed May 2024.
https://my.clevelandclinic.org/health/diseases/22497-pterygium-surfers-eye - Rezvan F, et al. Prevalence and risk factors of pterygium: a systematic review and meta-analysis. Journal of Current Ophthalmology. 2018;30(1). https://pmc.ncbi.nlm.nih.gov/articles/PMC5968422/
- American Academy of Ophthalmology. Management of Pterygium. EyeNet Magazine.
https://www.aao.org/eyenet/article/management-of-pterygium-2 - Better Health Victoria. Pterygium. https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/pterygium
- Vision Institute. Understanding Pterygium Surgery and Treatment Solutions.
https://www.vision-institute.com/pterygium-understanding-pterygium-surgery-and-treatment-solutions/
For appointments, call 1800 571 2222 or visit your nearest Vasan Eye Care centre.
Frequently Asked Questions (FAQs)
For mild pterygium that is not affecting vision, lubricating eye drops combined with consistent UV protection is the appropriate pterygium treatment. For pterygium that has grown onto the cornea, causes vision problems, or is significantly uncomfortable, pterygium surgery with conjunctival autograft is the most effective and lasting pterygium treatment. It removes the pterygium, restores the eye surface, and, when combined with postoperative UV protection, significantly reduces recurrence.
Stage 1 pterygium is confined to the white of the eye and has not reached the cornea. Stage 2 has just touched or entered the edge of the cornea. Stage 3 has grown across a significant portion of the cornea, producing distortion and blurring. Stage 4 has reached the centre of the cornea or is covering the pupil, causing severe vision loss. Pterygium treatment with drops is generally appropriate for Stage 1. Pterygium surgery is recommended from Stage 2 onward when the condition is progressive, and is particularly urgent in Stages 3 and 4.
A small, stable pterygium that is not causing vision problems can be managed long-term with lubricating drops and consistent UV protection. This pterygium treatment manages symptoms but does not remove the growth or stop it eventually progressing. Once a pterygium has grown onto the cornea and is distorting vision, surgery is the only way to remove it. No drops or non-surgical procedure can make an established pterygium shrink or disappear.
Preservative-free lubricating eye drops are the most useful for everyday pterygium treatment, reducing dryness, grittiness, and irritation. When the pterygium is actively inflamed, the doctor may prescribe a short course of mild steroid or non-steroidal anti-inflammatory drops. Over-the-counter eye-whitening drops are not appropriate for pterygium treatment as they mask progression without addressing the underlying condition. Always consult an eye specialist before starting drops for pterygium.
The pterygium surgery cost in India varies depending on the technique used, whether one or both eyes are treated, the type of grafting material, and the hospital or eye centre. Pterygium surgery in India is generally affordable compared to many other countries. At Vasan Eye Care, the pterygium surgery cost will be clearly explained during the consultation so you can make an informed decision before proceeding. Please contact your nearest Vasan Eye Care centre for a detailed estimate.
Recurrence is the most common concern after pterygium surgery. With older techniques where the pterygium was simply removed without a graft, recurrence rates were very high. With modern pterygium surgery using conjunctival autograft, recurrence rates are considerably lower. Consistently wearing UV-protective sunglasses after pterygium surgery is critical to keeping recurrence low.
Pterygium surgery is done under local anaesthesia and the patient feels no pain during the procedure. After pterygium surgery, the eye will be sore and red for a few days, managed with prescribed drops and standard pain relief. Most patients describe the post-operative discomfort as mild to moderate and manageable. Full comfort returns over one to two weeks.
Yes. Pterygium can develop in both eyes, though it often appears in one eye first. When both eyes are involved, pterygium surgery may be performed on each eye separately rather than at the same time, to allow proper healing. The pterygium treatment approach is the same for both eyes.
RELATED EYE CONDITIONS
- Pinguecula
- Dry Eye Syndrome
- Corneal Astigmatism
- Conjunctivitis
- Corneal Scarring
REFERENCES
- Cleveland Clinic. Pterygium (Surfer’s Eye): Causes, Symptoms and Treatment. Last reviewed May 2024. my.clevelandclinic.org/health/diseases/22497-pterygium-surfers-eye https://my.clevelandclinic.org/health/diseases/22497-pterygium-surfers-eye
- Rezvan F, et al. Prevalence and risk factors of pterygium: a systematic review and meta-analysis. Journal of Current Ophthalmology. 2018;30(1). pmc.ncbi.nlm.nih.gov/articles/PMC5968422 https://pmc.ncbi.nlm.nih.gov/articles/PMC5968422/
- American Academy of Ophthalmology. Management of Pterygium. EyeNet Magazine. aao.org/eyenet/article/management-of-pterygium-2 https://www.aao.org/eyenet/article/management-of-pterygium-2
- Better Health Victoria. Pterygium. betterhealth.vic.gov.au/health/conditionsandtreatments/pterygium https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/pterygium
- Vision Institute. Understanding Pterygium Surgery and Treatment Solutions. vision-institute.com/pterygium-understanding-pterygium-surgery-and-treatment-solutions https://www.vision-institute.com/pterygium-understanding-pterygium-surgery-and-treatment-solutions/
For appointments, call 1800 571 2222 or visit your nearest Vasan Eye Care centre.
