Pterygium excision is a 30 to 45 minute day-case operation to remove a pterygium, a fleshy growth spreading from the white of the eye onto the cornea. A thin patch of your own conjunctiva then covers the bare area, leaving a regrowth rate of about 10%. Mr Arthur Okonkwo, Consultant Ophthalmologist, sees patients at St James Laser Vision Clinic in Leeds.
His other Leeds cornea and lens operations are on the treatments page. The operation is offered when a pterygium causes redness, grittiness or blurred vision, or when you dislike how the eye looks, and Mr Okonkwo routinely uses the autograft method, with the eye numbed.
Concerned About a Pterygium?
Book to find out whether your pterygium needs removing now or can be watched, and bring your glasses and any optician’s report to Leeds.
Prefer to call? 0113 460 1923, Monday to Friday, 9am to 5pm
What Is Pterygium Excision?
A pterygium is a raised, wedge-shaped growth of the conjunctiva, the clear skin over the white of the eye. It is benign, usually starts nearest the nose and creeps slowly across the cornea, and it is linked to UV light and long-term irritation from dust and wind.
The operation has 2 steps. First the growth is lifted off the cornea, then a conjunctival autograft, a patch of healthy conjunctiva from under the upper lid, is moved over the bare area. It is fixed with dissolving stitches, tissue glue, or both, and Mr Okonkwo often uses glue.
His pterygium patient leaflet can be downloaded as a Word document, and his pterygium blog covers causes and early signs.
Pterygium Symptoms and When to Get Urgent Help
Redness, a dry or gritty feeling and blurred vision are typical, though some people notice only the change in how the eye looks. Other common causes of a red, gritty eye include dry eyes and blepharitis.
| Your symptom | Possible cause | What to do |
|---|---|---|
| Red, gritty eye with a fleshy wedge on the white | A pterygium, or a pinguecula | Routine check with your optician or GP |
| Blurred or changing vision as the growth spreads | The pterygium distorting the cornea | Ask your optician or GP for a referral |
| Very painful red eye, or red with contact lenses | Possible infection | Urgent GP or optician appointment, or NHS 111 |
| After surgery: worse vision, discharge or unrelieved pain | Infection or inflammation | Ring the eye team the same day |
| Sudden sight loss, or pain on looking at light | An eye emergency | Call 999 or go to A&E |
Conditions Mr Okonkwo Treats
- Primary pterygium: a first growth, removed with an autograft once it causes symptoms, with about 10% regrowth.
- Recurrent pterygium: regrowth after earlier surgery, sometimes with an anti-scarring medicine added.
- Pinguecula: a soft yellow nodule on the white of the eye, which rarely needs treatment.
- Dry eye: the raised edge can leave dry patches nearby, covered on dry eye procedures.
- Astigmatism: a large pterygium can warp the cornea, and this can improve after removal.
- Corneal scarring: a faint scar often stays where the growth sat, and deeper scarring is covered on corneal transplantation.
Treatment Options for a Pterygium
Of the 4 options below, only an operation removes a pterygium, while drops ease the symptoms but leave the growth where it is.
Lubricating Eye Drops
Artificial tears soothe the dry patches the raised edge can cause, for a small pterygium that is not affecting your sight. There is no procedure and no hospital stay, but the growth stays and may slowly enlarge.
A Short Course of Steroid Drops
Steroid drops calm redness and inflammation in a flare of an inflamed pterygium. A short course is prescribed in the Leeds clinic and used at home, and because they can occasionally raise eye pressure, it is checked.
Pterygium Excision with a Conjunctival Autograft
This is Mr Okonkwo’s routine method, for a pterygium that causes symptoms, grows towards the pupil or troubles you cosmetically. It takes 30 to 45 minutes as a day case. Regrowth is about 5% with an autograft.
Repeat Surgery with an Anti-Scarring Medicine
For a very large, progressive or regrown pterygium, an anti-scarring medicine may be applied during surgery, with theatre time, around 30 to 45 minutes, and the day-case stay similar to a first pterygium excision.
Not Sure Which Pterygium Treatment Is Right for You?
Mr Arthur Okonkwo will talk you through the options that suit your eye at your consultation.
Prefer to call? 0113 460 1923, Monday to Friday, 9am to 5pm
Why Patients Choose Mr Okonkwo
- Cornea focus: a dual fellowship-trained Consultant Ophthalmologist in Leeds, specialising in cornea, cataract and refractive surgery.
- Training: MBBS, Newcastle University, 2014, then academic posts in Leeds and Manchester.
- Fellowships: Moorfields Eye Hospital, London, and the Royal Victorian Eye and Ear Hospital, Melbourne.
- Qualifications: FRCOphth and CertLRS, a transplant MRes, a cataract and refractive PgDip, and a teaching PgCert; award years are.
- NHS work: leads NHS and private clinics at Leeds Teaching Hospitals NHS Trust.
- Teaching: Honorary Senior Lecturer, University of Leeds.
- Research: 30-plus published papers, mainly on the cornea, transplants and newer surgical techniques.
Will a Pterygium Grow Back After Surgery?
Sometimes. Regrowth, called recurrence, is about 5% when an autograft is used, and a further operation may then be needed. Covering the bare area with your own tissue is why the graft is part of the operation.
Waiting does not lower the chance of successful surgery later, so a small pterygium can be watched without losing options. UV light, dust and wind are triggers, so wear sunglasses outdoors before and after surgery, and avoid dusty work while healing. If the fleshy edge seems to be returning, raise it at your follow-up.
Alternatives to Pterygium Excision
Surgery is optional, and you do not need it if the pterygium causes no symptoms and its look does not worry you.
- Watching: your optician checks the size at routine tests.
- Lubricating drops: a pharmacist can suggest drops or gels for dry eyes.
- Short steroid courses: for redness, prescribed and reviewed in clinic.
- Sun and dust protection: sunglasses and fewer windy, dusty settings.
None of these 4 removes the growth, and extensive pterygium can also need amniotic membrane transplantation.
Your Pterygium Excision Pathway, Step by Step (Appointment, Tests, Surgery)
- Referral: a GP or optician letter helps but is not always needed privately, while NHS patients are referred by their GP or optician.
- First consultation: history, a slit-lamp examination and scans at St James; dilating drops blur vision for hours, so do not drive.
- Decision: Mr Okonkwo goes through the findings, and you choose between the 4 options of watching, drops, steroids and surgery.
- Treatment day: local anaesthetic and 30 to 45 minutes in theatre at [to confirm]. You go home the same day with the eye padded until morning.
- Follow-up: antibiotic and steroid drops at home, then a clinic check 1 week after surgery.
Recovery and Risks After Pterygium Excision
Expect soreness for about a week and redness for 2 to 4 weeks. Vision may blur for up to 6 weeks before settling.
Plan 1 to 2 weeks off work, or longer if your job is dusty. Wear the eye shield at night and skip make-up for 1 week. Swimming waits 4 weeks and strenuous exercise 2 weeks. Glasses may need updating if astigmatism improves.
| Treatment | Hospital stay | Example risk |
|---|---|---|
| Pterygium excision with an autograft | Day case, eye padded until the next day | Regrowth in about 5% |
| The same operation | Day case | Infection in fewer than 1 in 1,000 |
| Steroid drops afterwards | None, used at home | Allergy or a rise in eye pressure, checked in clinic |
| Any pterygium removal | Day case | A faint corneal scar, not usually affecting vision |
Infection is rare, at fewer than 1 in 1,000, helped by the antibiotic drops given afterwards. A surface that stays uneven may need more lubricating drops.
Where Mr Okonkwo Sees Patients
Pterygium consultations are held at St James Laser Vision Clinic, inside St James’s University Hospital.
| Location | Address |
|---|---|
| St James Laser Vision Clinic | Floor 4, Gledhow Wing, St James’s University Hospital, Beckett Street, Leeds LS9 7TF |
| Operating theatre for pterygium excision | St James’s University Hospital, Beckett Street, Leeds LS9 7TF |
The clinic phone, 0113 460 1923, is answered Monday to Friday, 9am to 5pm. When the clinic is closed, use NHS 111 for urgent questions, or 999 and the nearest emergency department in an emergency.
FAQs About Pterygium Excision
Is pterygium excision major surgery?
No. Expect 30 to 45 minutes in theatre and home the same day. You stay awake while drops or a small injection numb the eye.
How long does recovery take after pterygium surgery?
About a week of soreness and 2 to 4 weeks of redness. Blurring can last up to 6 weeks.
When can I drive after pterygium excision?
Not that day, as the eye is padded until the next morning. Wait until your vision is confirmed safe, usually once it settles.
Can a pterygium come back once it has been removed?
Yes, in about 5% with an autograft, and a further operation may be offered.
Is there a non-surgical alternative for a pterygium?
Drops ease dryness and redness, but only surgery removes the growth, and watching is reasonable while it causes no symptoms.
Will I feel anything during the operation?
Very little. Local anaesthetic numbs the eye. An injection near the eye stings briefly, and light sedation is an option.
Why does my eye look so red after the operation?
Bleeding during surgery and inflammation, which can take up to 4 weeks to fade.
When can I work again after pterygium excision?
Usually after 1 to 2 weeks, longer in dusty work.
When can I swim or exercise again?
Avoid swimming for 4 weeks and strenuous exercise such as jogging for 2 weeks.
Will I still need glasses after pterygium excision?
Yes, if you needed them before, though the prescription may change if astigmatism improves.
Quick Info
What is it?
Removal of the growth, then a patch of your own conjunctiva over the area
Who is it for?
A pterygium causing symptoms, or a look you are unhappy with
How long does it take?
Usually 30 to 45 minutes
Hospital stay
Day case: home the same day, eye padded until the next day
Recovery
Sore for about a week, red for 2 to 4 weeks
Ready to Get Started?
Book a consultation to discuss your symptoms and treatment options.
Book a Consultation with Mr Arthur Okonkwo
Book to find out whether your pterygium needs removing now or can be watched, and bring your glasses and any optician’s report to Leeds.
- Phone: 0113 460 1923, open 9am to 5pm on weekdays
- Online: choose a consultation time or send photos or questions
For a painful red eye or worsening vision, see your GP or optician urgently, or call NHS 111. Sudden loss of sight, eye trauma or possible sepsis needs 999 or A&E.