Pterygium & Pinguecula Removal Surgery
A pterygium is a triangular-shaped growth of fleshy tissue that develops on the white of the eye and can extend onto the cornea, sometimes affecting vision and comfort. Dr Zoran Aleksic assesses and treats pterygium and pinguecula at The Eye Surgery, with consultations in Sea Point and Vredenburg, and surgery performed at Life Peninsula Eye Hospital in Claremont or Life West Coast Private Hospital in Vredenburg.
What Is a Pterygium (Surfer's Eye)?
A pterygium is a growth of fibrous tissue on the conjunctiva — the thin membrane covering the white of the eye — which can gradually extend onto the cornea, the clear front surface of the eye. It often begins as a pinguecula, a smaller, yellowish growth that can develop into a pterygium over time. The exact cause isn't fully understood, but ultraviolet (UV) light exposure, along with environmental factors such as wind and dust and chronic dry eye, are believed to contribute to their development.
A pterygium may stay small and cause little more than mild redness or irritation. In some cases it becomes red, swollen, or thickened, giving a persistent sensation of something in the eye. If it grows large enough to encroach on the cornea, it can distort the eye's surface and lead to astigmatism, affecting vision.
Treatment Options
Not every pterygium needs surgery. Many can be managed with artificial tears, lubricating ointments, or short courses of steroid eye drops to settle inflammation and irritation. Surgery is generally considered when the growth causes persistent discomfort, is cosmetically bothersome, or has grown enough to threaten or affect vision.
If left untreated, a pterygium on its own usually causes no more than ongoing redness and irritation. However, if it continues to grow across the cornea, it can begin to affect vision. Long-term use of anti-inflammatory drops to manage symptoms can also, over time, bring its own complications, which is worth discussing with Dr Aleksic if drops are being used regularly.
What Pterygium Surgery Involves
Pterygium excision is performed as a day case procedure in theatre, usually under local anaesthetic given as eye drops or an injection around the eye. Some patients are offered a sedative or, less commonly, a general anaesthetic — Dr Aleksic and the anaesthetist will discuss the most suitable option for you beforehand. The procedure itself takes approximately 30 minutes per eye.
Dr Aleksic uses a technique that involves grafting a small piece of tissue from elsewhere on the eye's surface to cover the area where the pterygium was removed. The graft is secured with tissue glue rather than sutures, which is generally more comfortable for patients during healing than a stitched repair. Most patients are able to return to work within a couple of days, though this varies from person to person.
As with any eye surgery, it isn't possible to list every risk that could arise, and Dr Aleksic will talk you through the risks most relevant to your individual case during your consultation. Recognised risks of pterygium surgery include infection, bleeding, scarring, dry eye, graft-related complications, and recurrence of the pterygium, among others. Some of these may require further treatment. No specific outcome can be guaranteed.
Recovery and Aftercare
You'll leave with an eye pad over the operated eye, which should stay on overnight and be removed the following morning to begin your prescribed eye drops, unless Dr Aleksic advises otherwise. Redness, watering, irritation, and light sensitivity are all normal in the days following surgery, and any blood visible in the white of the eye will clear on its own.
In general, the eye tends to feel most irritated on the day of surgery and the day after, gradually settling from there. Redness can persist for one to three weeks, and light sensitivity is common during recovery, so sunglasses can help. Avoid rubbing the operated eye and wearing eye makeup for two weeks, and avoid swimming pools, hot tubs, and other untreated water for two weeks, taking care not to let shower water spray directly onto the face. Rest is encouraged in the first 24 hours, along with avoiding alcohol for 24 hours and strenuous exercise for 2–4 days.
You'll have a scheduled follow-up appointment to monitor healing, and Dr Aleksic and the healthcare team remain available if you have any concerns during your recovery.
Medical Aid and Cost
Pterygium surgery is not automatically covered in full by medical aid, and cover varies from scheme to scheme. We recommend confirming your benefits, authorisation requirements, and expected reimbursement rate with your scheme ahead of time. You'll receive a cost estimate at your consultation, valid for one calendar month, and can expect separate accounts for the surgeon's fee, the hospital, the anaesthesiologist, and pathology if applicable.
Frequently Asked Questions
Is a pterygium the same as a cataract?
No. A pterygium is a growth on the surface of the eye, while a cataract is a clouding of the lens inside the eye. They're unrelated conditions, though both are more common with age and lifetime UV exposure, and in some cases both can be addressed during the same surgical visit if needed.
Is pterygium surgery painful?
Most patients experience mild discomfort rather than significant pain, and this is usually well controlled with simple painkillers such as paracetamol.
Will the pterygium grow back?
Recurrence is possible with any pterygium surgery technique, though the graft technique Dr Aleksic uses is intended to reduce this risk. No outcome can be guaranteed, and Dr Aleksic can discuss your individual likelihood of recurrence during consultation.
How soon can I return to normal activities?
Many patients return to work within a couple of days, though swimming, eye makeup, and strenuous exercise should be avoided for the periods outlined above. Please also plan to remain within the Cape Metro area for at least two weeks after surgery, so you're available for your follow-up appointment and any early checks your surgeon needs to do.
Can pterygium surgery correct the astigmatism it caused?
Removing a pterygium can sometimes improve astigmatism it has caused, though this isn't guaranteed and depends on how long the growth was present and its effect on the cornea. If astigmatism remains afterwards, laser eye surgery may be an option worth discussing at a later consultation.
If you'd like to find out more, book a consultation with Dr Zoran Aleksic at The Eye Surgery in Sea Point or Vredenburg. You can also read patient reviews online.