Pterygium Treatment, Best Drops to Try, Follow Up:
Most pterygia can be safely left alone and just watched and followed through time. Patients can do this reasonably well just looking in the mirror although some components of the pterygium near the pupil may be difficult to detect without magnification.
If you have or suspect you have a pterygium, see your eyeMD or optometrist every year or two to check that the pterygium is not growing.
In those patients in whom redness is the main concern, the occasional use of an over the counter drug such as Naphcon-A ®, Naphcon Forte®, Albalon ®, Albalon Relief®, Albalon-A®, Antistine- Privine Eye Drops®, Murine Clear Eyes®, Murine Sore Eyes®, Optazine®, Prefrin ®, Prefrin-Z® or Visine Allergy®*, can give temporary relief for important social occasions or times when the eye is very irritated. However, long-term and frequent use of such eye drops is not advisable as the eye can become increasingly red on withdrawing these drops. Toxic reactions, allergies and side effects can occur as a result of the long-term use of these drops
In some cases, surgery may be the appropriate method to treat this condition. If over counter drops do not give sufficient relief for chronic irritation and redness or if the cosmetic effect of the pterygium is undesirable or if the pterygium causes chronic discomfort and pain or the vision is being altered, surgery is the best option.
There is no perfect method of removing a pterygium. The major complication of pterygium removal is that the pterygium can recur, and sometimes when it recurs it may be larger and more troublesome than the pterygium that was removed. The risk of recurrence varies according to the scientific reports 5 percent and perhaps up to 15 percent. If a pterygium is going to recur, it usually will start to recur within the first year.
There are at least a dozen methods of removing a pterygium but a conservative approach would suggest that it is preferable not to use additional “chemo” drugs or radiotherapy if this can be avoided. The potential for long-term side effects from these methods, which are advocated by some surgeons, is such that extreme caution needs to be exercised in their use.
Although there would be considerable dispute about the method of pterygium removal which is most successful in preventing a recurrence, it is my view and the view of many other pterygium surgeons that removal of the pterygium and filling the resultant defect on the surface of the eye with a piece of membrane (conjunctiva) taken from another place on the surface of the eye is the technique associated with the least risk and the highest success rate. This is called a pterygium removal with autoconjunctival transplant or conjunctival autograft. I use a conjunctival autograft in all my surgeries for this reason. We are currently conducting outcomes research to evaluate and publish our low recurrence rates and cosmetic outcomes.