The pterygium on the eye (or wing fur) is a tissue proliferation of the conjunctiva in the form of a triangle.
The conjunctiva is a transparent thin membrane that covers the anterior surface of the eyeball.
In most cases, a pterygium grows in the inner corner of the eye (near the nose).
However, it can sometimes grow at the outer angle or on both sides of the eye.
The pterygium can occur unilaterally or bilaterally.
This condition is:
- does not penetrate the eye,
- does not spread to other areas of the face or body.
If left untreated, a pterygium can grow through the cornea (the transparent window that covers the pupil and iris), impair vision and become more and more visible.
The wing fur occurs mainly in older people and adults from the age of 50, in children it is extremely rare.
A pinguecula is a yellowish structure or a growth on the conjunctiva, usually located near the nose.
It is not a tumor, but a change in normal tissue, which subsequently becomes a gathering place for proteins and fats.
Unlike the pterygium, a pinguecula does not actually grow on the cornea.
Properties of pterygium
A pterygium consists of three different parts: head (tip of the triangle), body and tail.
- The body, or main margin, is a flat zone on the cornea consisting mainly of fibroblasts that spread fan-shaped on the eyeball, destroying the Bowman’s membrane.
- The head is a vascularized area that has a rounded or pointed shape, has more or less regular edges and forms a different height to the cornea, to which it is firmly connected.
- The neck/movable tail of the bulbar conjunctiva can be easily separated from the underlying tissue.
Stocker’s line is an iron deposit in the basal epithelial layer of the cornea that occurs when the pterygium is chronic.
What are the causes of pterygium?
According to conventional medicine, the exact causes of pterygium are unknown, it is assumed that it arises from various factors that interact with each other.
Ultraviolet (UV) light from the sun is the most likely factor involved in the development of this condition.
Hours of sunlight exposure in a dry and dusty atmosphere appear to play an important role in the development of a pterygium.
According to natural medicine and the theory of blood type diet, any disease begins due to poor nutrition and an inappropriate way of life.
The health of the eyes depends on:
- toxins contained in the blood,
- blood sugar,
- cholesterol and triglycerides in the blood,
Symptoms of pterygium
Symptoms of pterygium may include:
- whitish growth with raised blood vessels in the inner and/or outer corner of the eye;
- reddened eyes in the affected area;
- Dry eyes;
- watery eyes;
- foreign body sensation;
- blurred vision, loss of vision (in advanced cases, when the growth extends over the central area of the cornea;
- Double vision (diplopia) in side view;
- Astigmatism due to the tension exerted on the corneal surface).
Diagnosis of pterygium
As a rule, an examination with the slit lamp is sufficient for the diagnosis. However, in some cases, the lesion must be removed and subjected to an examination to establish an accurate diagnosis.
What is the therapy for pterygium?
At a very early stage, when there are no symptoms yet and the pterygium has not yet become aesthetically noticeable, it can be neglected.
If the pterygium causes irritation, redness and discomfort, artificial tear fluid can help to moisturize the eye and relieve the discomfort.
However, eye drops do not affect the growth of the pterygium.
There is no consensus in the scientific world regarding a specific medical and surgical treatment of the pterygium on the eyes.
In the case of a mild form of wing fur, doctors usually follow a conservative therapeutic approach and limit themselves to the use of lubricant medication.
Because UV radiation is thought to be a significant risk factor, doctors should advise their patients to wear goggles in the early stages of the disease.
Contract lenses should be avoided.
Natural remedies for pterygium
The best natural remedy is a diet that provides good blood; the diets that usually show the best results are:
- vegan diet/raw food,
- Blood group diet.
Diet and nutrition in pterygium
According to Shelton’s natural medicine and hygienism, drugs and surgical interventions do not solve the problem, but can cause further discomfort.
Naturopaths recommend a fasting cure to eliminate:
- other anomalous formations.
The body needs to protect the vital organs, so it uses up fatty tissue and unnecessary tissue as fuel.
Fasting is contraindicated for:
- pregnancy, especially in the 2nd and 3rd trimester of pregnancy,
- extreme weakness due to cancer,
- Organ transplant
No medication may be taken during the fasting cure.
According to Shelton and Lezaeta, in cases where fasting is out of the question, a diet based on fruits and raw vegetables can be followed.
According to the theory of the blood group diet, there are permissible and forbidden foods depending on the blood group.
In principle, the following should be avoided:
- milk and dairy products,
- smoked and fried foods,
- excess of fruits, nuts and seeds,
- too much grain.
According to this diet, the following foods are recommended:
- nuts (without exaggerating),
When to operate on pterygium?
If the pterygium is aesthetically noticeable or causes symptoms such as blurred vision, the doctor may recommend surgical removal.
Surgical intervention for pterygium
The main challenge for the surgeon in a pterygium is to avoid recurrences in which fibrovascular growth occurs in the limbus of the cornea.
Many surgical techniques have been performed, although none of them can be considered generally useful due to the different rates of recurrence. Regardless of the technique used, removing the pterygium is the first step to healing.
Many eye specialists prefer to separate the head of the pterygium from the underlying cornea.
- faster epithelization,
- minor wound,
- smoother corneal surface.
Surgical techniques for pterygium
Over the years, surgeons have used various techniques to reduce the risk of recurrence, including radiation therapy and the use of “antimetabolic” chemicals (mitomycin C) that prevent tissue growth. Each of these techniques carries risks that potentially threaten eye health after surgery, including:
- permanent epithelial defects (ulceration on the surface of the eye),
- Corneal fusion.
Autologous corneal graft with sutures
Most corneal specialists today perform pterygium surgery with an autologous corneal graft to reduce the risk of recurrence.
In this technique, the pterygium is removed and the cornea appears clear again.
The dent in the mucous membrane (cornea) where the pterygium was removed is filled with a tissue graft painlessly taken under the upper eyelid.
An excimer laser allows the cornea to be smoothed before transplantation.
Even though the procedure requires excellent surgical skills, this autologous graft (autograft) helps prevent pterygium regrowth by filling the space with healthy tissue.
In conventional operations with autologous material, sutures are used to protect the graft in the eye.
These can cause discomfort over a few weeks.
The autograft is positioned with small sutures that:
- are absorbed after a few months,
- can be removed in a surgical outpatient clinic.
The sutures often cause discomfort after pterygium surgery with autograft.
The desire for a quick and painless recovery has led to transplanting autologous grafts in pterygium surgery without sutures.
Transplantation of autologous material in pterygium with fibrin adhesive (without suture)
This type of surgery allows most patients to return to work within a few days of the procedure.
A study conducted on 85 patients with a pterygium at Harvard Eye Associates showed that patients who underwent seamless surgery experienced much less postoperative pain than those who had undergone conventional surgery.
Instead of the suture, the surgeon used a biological or fibrin-containing adhesive.
The seamless technique has also reduced the operation time to an average of 30-45 minutes.
None of the patients in the study had recurrences of the pterygium.
Technique of suture-free surgery of the pterygium with autolog graft
In the suture-free operation, the patient is slightly sedated to ensure a certain level of comfort and the eye is completely anesthetized with a local anesthetic, so that the procedure is neither seen nor discomforted.
The abnormal corneal tissue is removed and replaced with a thin graft of the normal cornea.
In the following 2-3 weeks, the eye gradually regains its normal appearance.
After surgery for pterygium
In the first two days of the postoperative course, the doctor may recommend anti-inflammatories or analgesics.
After the operation, it is necessary:
- to keep the eye very clean;
- to put on a sterile bandage for a few days and for the first 3 weeks every time you take a bath or shower or if you are in an unclean environment;
- take special care with irritating substances (shampoo);
- avoid touching and rubbing the eye;
- protect the eyes from the sun with sunglasses or a sun hat.
The time in which infection can occur is about 3 weeks after the procedure.
After this time, you should refrain from swimming for another month.
The doctor prescribes drops with cortisone for 20 days and antibiotic drops for a week.
An aggravation should be reported immediately to the doctor:
- of pain,
- of redness.