I wrote this page so that others who may be going through, or considering a pterygium removal can get a patient’s point of view of the procedure and recovery.
What is a pterygium?
The Optometry Australia website describes a pterygium (pronounced ter-idge-ee-um) as
“a triangular-shaped lump of tissue with blood vessels that grows from the conjunctiva (the thin membrane that covers the white of the eye) on to the cornea (the clear central part of the eye).”
Pterygium growth is strongly associated with exposure to UV light. They are not a problem unless they grow to a size where they start to affect vision by growing over the cornea, or causing corneal distortion.
Pterygia can be removed by a surgical procedure performed under a local anaesthetic, where the pterygium is cut off, and then a graft of conjunctiva from under the eyelid is sewn over the excised area of the cornea.
I’ve had a pterygium in my right eye for years. My wife, who once worked as an orthoptist, noticed it over a decade ago. Seven years ago when I first had to get reading glasses, the optometrist noted it also. At this time it was only small and not bothering me in any way. With regular eye checkups the optometrist kept track of the pterygium, and not much changed, until my checkup last year, when she noted that the pterygium had grown a lot in the past two years, and if left untreated would begin to cover my iris and affect my vision.
A subsequent appointment with an opthalmic surgeon confirmed that removal of the pterygium was recommended.
Friday 9th February 2018. The surgery was booked for first thing in the morning and I arrived at the eye centre at 7am. It seems I was only the second patient for the day, so there was no waiting, and everything progressed without delay, and great efficiency. An interview with the nurse, a few doses of anaesthetic eye drops, and before long I was in the operating room.
I found the surgery itself quite disorientating, lying down in a chair with a mask over my face, so that I couldn’t see anything with my left eye. My right eye was just a blur, presumably the effect of the anaesthetics. There were bright lights above, and the surgeon and nurse were just disembodied voices around me. At one point the surgeon asked me to “look down”, which really confused me. I’m lying flat on my back with my eyes to the ceiling – how can I look down? Of course what he meant was look towards my toes.
Before the procedure I had asked the nurse how long it would take. She said 5 minutes. It certainly felt more like more than 5 minutes, probably closer to 10 minutes. The actual procedure wasn’t painful, but I would describe it as uncomfortable.
After the surgery the nurse explained the post operative care I would need. The eye was to be kept bandaged until the following morning, and then I would need to administer an anti inflammatory eye drop every two hours for a week (reducing to 4 times a day for another 4-6 weeks), plus an antibiotic eye drop four times daily for a week.
I was back in the reception desk with everything done, ringing for my lift to pick me up, by 8:30am
Travelling home after surgery the anaesthetic still hadn’t worn off, so I don’t look too pained in the picture above. That would change.
About an hour after surgery the pain really kicks in. It feels like there are tiny shards of glass in my eye. Any movement of my eye, however slight, is painful. As my eye is covered with a bandage, and must remain that way until the next morning, the only pain relief available is Paracetamol. It doesn’t help much. Although I can see with my left eye, it is very hard to do so as every movement of my left eye in order to focus on something causes pain in my right eye. To minimise this I spend most of the day with eyes closed.
I have to move around my house by memory and feel. Fortunately our house is fairly open and uncluttered so I manage to get through the day with crashing or tripping. To pass the time I listen to music a lot, and I get to use Siri (voice recognition) on my phone a lot that day.
If I have to open my left eye to look at something I have to concentrate on keeping my eyes completely still, and move my head around instead of my eye. I must have looked odd doing that.
By evening the pain is such that I feel like if I had known beforehand that it was going to be like this I wouldn’t have had the surgery.
I had a poor night’s sleep and I’m really tired today. The eye was still really painful when I woke up. After removing the bandage over the and washing carefully with clean water, and administering the anti-inflammatory eye drop, the sharp pain dissipated surprisingly. It now feels like a stinging sensation, like getting shampoo or soap in the eye.
I find that I’m sensitive to bright light, even in my good eye. I had to shower in semi darkness with the aid of just an LED night light as the normal lighting is too bright. I still have to spend a lot of time with both eyes closed, or wearing sunglasses.
I can open my eyes for short periods today, and so it’s only now that I get to read the post-operative care instructions that the nurse gave me yesterday. Here’s a tip for optical surgery providers … give the post-op instructions to your patients to read before you temporarily incapacitate their vision. Just a suggestion.
I’m still quite sensitive to bright light and I find it helpful to wear sunglasses indoors. I try to do some reading and using computer today. In particular I have to use the computer to finish and submit next month’s article for my local history column. (I really should have finished that before I let a stranger come at my eye with a sharp knife.) Overall I think I overdo the screen time and by bedtime my eye feels very strained and sore.
I was supposed to go back to work today but although I can see, looking at a computer screen is extremely difficult after 5 minutes. As a software engineer, pretty much my entire working day involves looking at a computer screen, so going to work is not an option. I stay home and try to rest as much as possible. I pluck up the courage to photograph my eye so that I can see what it looks like. It was pretty much as I expected – very red.
By the afternoon I found that I could look at screens longer. Maybe I’ll be back to work tomorrow?
After being inside my house for 3 days, in the evening I go for a walk in the local park, but even with the low light of dusk, and with sunglasses on, I find it uncomfortable.
First day back at work today. With the level of irritation I was still experiencing, I wasn’t entirely ready to go back, but I’m getting tired of lying around doing nothing. I’m not up for driving a car yet, but that’s not an issue as I cycle to work. I found that I had to cycle slower than usual so as to not have too much air rushing past my eye, which irritates it.
Overall the first day back at work goes OK, but when I get home, after dinner all I can manage is to lie in bed with eyes closed listening to music.
Back at work again today. Some colleagues comment that the eye doesn’t look too bad, but I can easily elicit gasps and groans by looking up and to the right to reveal the full extent of the blood shot region of my eye.
Post operative follow up appointment with an optometrist at the eye centre today. She said the graft was taking well but the eye was still quite irritated and swollen. Although the initial instructions were to use the anti-biotic eye drops 4 times a day for the first week, she tells me to continue with the antibiotic drops for another week.
She also tells me that recovery from pterygium surgery is more painful than cataract surgery, and that my pterygium was a large one. Nice to know – I thought I was just being a wuss. I now have grounds to angle for more sympathy.
I was driven to work by my daughter. Today is probably the first day that I could possibly drive a car if absolutely necessary, but I prefer not to.
Its been one week since the surgery. This is the first morning I’ve woken up where the eye felt less irritated than the previous morning. There’s less of a stinging sensation, and more like a feeling that there’s some grit or fluff in the eye. It’s hard to resist the urge to rub the eye. That of course only exacerbates the irritation.
As I work a four day week, today being Friday is a non-work day and I get to rest a bit. I’m feeling sufficiently unmiserable to laugh at our cat who decides that my belly is a nice place to go to sleep. She’s never done that before. Maybe I’ve been lying down so much in the past week she now thinks I’m part of the furniture.
By the end of the day my eye was back to the stinging sensation. Frustrated at the slow progress, I Google pterygium surgery recovery. There are lots of sites with information from medical providers, but I also find few helpful accounts from the patient’s point of view. It seems that my recovery is in line with what others experienced. I wish that I had known this before I embarked on this procedure.
At this point I decide that it would be good to write up my own story so that others can benefit in the future. I start to make a few notes in preparation.
I woke up this morning with no noticeable improvement from yesterday morning. Dang this is slow. Much patience is needed.
I find that moving air irritates my eye, so I find it hard to be outside in a breeze, or in a room with a fan. Fortunately the weather has been mild in the last week.
I’m getting tired of having to administer eye drops every two hours. It’s so constant that it becomes hard to remember when I last did it and when it’s next due.
Today was another opportunity for rest. I don’t know whether my sleep is still being affected, but I found that just lying down for a while doing nothing made me very sleepy.
I had constipation this morning. I never have constipation. Is this a side effect of the antibiotic eye drops? Or is it because I’m doing a lot less physical activity as I lie down a lot more in order to rest they eye? Or just a coincidence? Who knows? I aim to eat more fruit today.
I take another photograph of my eye. Not pretty.
I collect together all the notes I’ve been making and photographs I’ve been taking, and publish this page to my website.
There has been a definite turn for the better today. The irritation is less and several times I was late taking the 2 hourly drops. I was able to catch up on and reply to a bunch of emails that have been waiting in my inbox over the last fortnight.
I’ve been concentrating so much on administering my eye medication every 2 hours, that I realised this morning that I’ve missed taking my blood pressure medication for the last 4 days. Oops.
Back to work today again and my eye definitely has less of a stinging soreness, and more of a dry itchiness. I find that I have to lower the brightness on my computer screens. I also have to periodically close my eyes for 30 seconds or so to rest them. I suspect that the air conditioning vent directly above my desk might be a contributor to the irritation. I could move to a different desk, but there doesn’t seem to be any spare desks that are better situated than my current one.
It was very windy today cycling to work, and it was a bit annoying for my right eye. Perhaps I shouldn’t have cycled? In the recovery process there is a constant navigation between the extremes of lying down and doing nothing for weeks on the one hand, and putting aside the discomfort and just getting on with normal life on the other hand. Despite the discomfort while cycling, I had minimal issues once I was at work.
I’m still waking up each morning with my right eye gummed up, and I have to gently wash it out with warm water. How much this is caused by the eye healing up or by the accumulation of antibiotic and anti inflammatory eye drops, I can’t tell.
Today is the last day for the antibiotics. I’ve been taking this 4 times a day and the anti inflammatory 8 times a day. This means 12 drops a day over 12 days, for a total of 144 drops. I’m tempted to make a joke about this being gross, but to be fair it’s just tedious.
From tomorrow I’ll just be taking the anti-inflammatory 4 times a day. I’ll see if that makes any difference to morning gumminess.
Today was the first day that I got through the whole day at work without my eye causing disruption. Although it is still a little sore, I didn’t really notice it while I was concentrating on work.
I drove a car for the first time today after the surgery two weeks ago. I probably could have driven a week ago, but I’ve had no need to use the car until today. The eye is still very red.
Pretty much all the soreness and irritation in my eye has gone now. Occasionally I get a slight feeling in the eye like a bit of dust has got in the eye. The colour of the eye has faded to a dark pink, from the stark red that it was last week. At work yesterday, two colleagues unprompted remarked that the eye was looking much better.
It was very windy when cycling to work this morning, and I thought to myself that my right eye wasn’t bothered by the wind like it was a couple of weeks ago on a really windy day. However it must have had an effect, because by mid morning at work the eye felt dry and irritated.
There’s been a big gap since the last update, because about six weeks after the operation all the irritation had gone, and there was no daily reminder that I’d had eye surgery. It probably took about another two months for most of the redness to subside.
My eyesight in the operated eye has had a some small improvement, it is less blurry than it was before, but not a huge difference. However, I had the surgery to avert future vision problems, not to fix existing vision problems.
In summary, there was a period of about a week after the operation where the pain and discomfort were such that I wished I hadn’t had the surgery. Five months on, the trauma of it all is a distant memory and I’m glad I did it.
About a year after my surgery I began to experience some irritation in my eye and was worried that the pterygium was growing back again. I visited the optometrist who advised me that the irritation was nothing to do with the pterygium, but was a condition called blepharitis. Blepharitis is usually easily treated, in my case by regular cleaning of the eyelids and eyelashes with a cleansing foam.
The moral of the story – make sure you get good advice from an appropriate medical professional.