eMedicine Specialties > Ophthalmology > Conjunctiva

Pterygium: Treatment & Medication

Author: Jerome P Fisher, MD, FACS, Volunteer Assistant Professor, Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami School of Medicine
Coauthor(s): William B Trattler, MD, Ophthalmologist, The Center for Excellence in Eye Care; Volunteer Assistant Professor of Ophthalmology, Bascom Palmer Eye Institute
Contributor Information and Disclosures

Updated: Jan 12, 2009

Treatment

Medical Care

Patients with pterygia can be observed unless the lesions exhibit growth toward the center of the cornea or the patient exhibits symptoms of significant redness, discomfort, or alterations in visual function. Pterygia can be removed for cosmetic reasons, as well as for functional abnormalities of vision or discomfort.

Surgical Care

Surgery for excision of pterygia is usually performed in an outpatient setting under local or topical anesthesia with sedation, if necessary.
 
Postoperatively, the eye is generally patched overnight, and it is treated subsequently with topical antibiotics and anti-inflammatory drops and/or ointments.

Medication

Medical therapy of pterygia consists of over-the-counter (OTC) artificial tears/topical lubricating drops (eg, Refresh Tears, GenTeal drops) and/or bland, nonpreserved ointments (eg, Refresh P.M., Hypo Tears), as well as occasional short-term use of topical corticosteroid anti-inflammatory drops (eg, Pred Forte 1%) when symptoms are more intense. In addition, the use of ultraviolet-blocking sunglasses is advisable to reduce the exposure to further ultraviolet radiation.

Artificial tears (topical lubricating drops)

To lubricate the ocular surface and to fill in defects in the tear film.


Artificial tears/topical lubricating drops (Refresh Tears, GenTeal [OTC])

Artificial tears provide topical ocular surface lubrication in patients with irregular corneal surfaces and irregular tear films. These conditions are very common in the setting of pterygium.

Adult

1 gtt in affected eye(s) qid and prn for irritation

Pediatric

Administer as in adults

Pregnancy

A - Fetal risk not revealed in controlled studies in humans

Precautions

If symptoms persist despite continued use, reevaluate patient

Topical lubricating ointments

A more viscous lubricant of the ocular surface.


Topical lubricating ointments (Hypo Tears, Refresh P.M. [OTC])

A relatively more viscous lubricant for the ocular surface. These thicker preparations tend to blur the vision temporarily; therefore, they are generally used at night, except in patients with severe discomfort.

Adult

Apply to inferior cul-de-sac in affected eye(s) hs

Pediatric

Administer as in adults

Pregnancy

A - Fetal risk not revealed in controlled studies in humans

Precautions

Patients using ocular ointments will have temporary blurring of vision and should avoid activities that require clear vision until the blurring subsides

Anti-inflammatory drops

To reduce inflammation on the ocular surface and other ocular tissues. Corticosteroids can be helpful in the management of inflamed pterygia by reducing the swelling of the inflamed tissues of the ocular surface adjacent to the lesions.


Prednisolone acetate (Pred Forte 1%)

A topical corticosteroid suspension used to reduce inflammation in the eye. Use should be limited to eyes with significant inflammation not relieved by topical lubricants.

Adult

1 gtt qid in affected eye(s) for a limited time, usually only 1-2 wk of continuous therapy

Pediatric

Not applicable, as pterygia are very rare in pediatric age group

Documented hypersensitivity; patients with a history of herpes simplex dendritic keratitis or steroid responsive glaucoma

Pregnancy

B - Fetal risk not confirmed in studies in humans but has been shown in some studies in animals

Precautions

Can be absorbed systemically but systemic adverse effects are generally not seen in patients using topical prednisolone acetate drops; can be excreted in the milk of women who are breastfeeding

More on Pterygium

Overview: Pterygium
Differential Diagnoses & Workup: Pterygium
Treatment & Medication: Pterygium
Follow-up: Pterygium
References
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References

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Further Reading

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Keywords

pterygia, ocular mass, ocular lesion, corneal surface, corneal topography, diplopia, double vision, vision loss

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Contributor Information and Disclosures

Author

Jerome P Fisher, MD, FACS, Volunteer Assistant Professor, Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami School of Medicine
Jerome P Fisher, MD, FACS is a member of the following medical societies: American Academy of Ophthalmology, American College of Surgeons, American Medical Association, and Florida Medical Association
Disclosure: Nothing to disclose.

Coauthor(s)

William B Trattler, MD, Ophthalmologist, The Center for Excellence in Eye Care; Volunteer Assistant Professor of Ophthalmology, Bascom Palmer Eye Institute
William B Trattler, MD is a member of the following medical societies: American Academy of Ophthalmology and American Society of Cataract and Refractive Surgery
Disclosure: Nothing to disclose.

Medical Editor

Fernando H Murillo-Lopez, MD, Senior Surgeon, Unidad Privada de Oftalmologia CEMES
Fernando H Murillo-Lopez, MD is a member of the following medical societies: American Academy of Ophthalmology
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

Christopher J Rapuano, MD, Professor, Department of Ophthalmology, Jefferson Medical College of Thomas Jefferson University; Co-Chairman of the Cornea Service, Co-Chairman of Refractive Surgery Department, Wills Eye Institute
Christopher J Rapuano, MD is a member of the following medical societies: American Academy of Ophthalmology, American Society of Cataract and Refractive Surgery, Eye Bank Association of America, Pennsylvania Medical Society, and Philadelphia County Medical Society
Disclosure: Allergan Honoraria Speaking and teaching; Allergan Consulting fee Consulting; Alcon Honoraria Speaking and teaching; Inspire Honoraria Speaking and teaching; RPS Ownership interest Other

CME Editor

Lance L Brown, OD, MD, Ophthalmologist, Affiliated With Freeman Hospital and St John's Hospital, Regional Eye Center, Joplin, Missouri
Disclosure: Nothing to disclose.

Chief Editor

Hampton Roy Sr, MD, Associate Clinical Professor, Department of Ophthalmology, University of Arkansas for Medical Sciences
Hampton Roy Sr, MD is a member of the following medical societies: American Academy of Ophthalmology, American College of Surgeons, and Pan-American Association of Ophthalmology
Disclosure: Nothing to disclose.

 
 
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