Pterygium Treatment with Lubricating Eye Drops
Lubricating eye drops are used only for symptomatic relief of ocular surface discomfort in pterygium, but they do not treat the underlying condition—surgery is the definitive treatment when intervention is needed. 1, 2
Role of Lubricating Drops in Pterygium Management
Lubricating eye drops serve a limited, palliative role in pterygium:
Preservative-free lubricants are recommended postoperatively after pterygium excision to support ocular surface healing and reduce discomfort. 3
Drops may provide symptomatic relief for dry eye manifestations that can accompany pterygium, such as burning, itching, and tearing, particularly in early stages when the lesion is asymptomatic or minimally symptomatic. 2
Lubricants do not prevent progression of the fibrovascular growth across the cornea or address the underlying pathology driven by UV radiation, inflammatory cytokines, and matrix metalloproteinase elaboration. 1, 2, 4
When Surgery Becomes Necessary
The primary treatment for pterygium is surgical excision, indicated when: 1, 2
- Visual acuity becomes compromised due to growth toward the optical zone
- Increasing corneal astigmatism develops
- The lesion threatens invasion of the visual axis
- Significant ocular surface discomfort persists despite conservative measures
Optimal Surgical Approach to Minimize Recurrence
Modern pterygium surgery aims to both remove the lesion and prevent recurrence through: 3, 5
- Optimal surgical technique: Conjunctival autografting or amniotic membrane transplantation rather than bare sclera excision (which has high recurrence rates) 1, 5
- Intraoperative adjuvants: Mitomycin C, 5-fluorouracil, or VEGF inhibitors to reduce recurrence risk, though these must be used judiciously due to potential sight-threatening complications 1, 2, 5
- Postoperative regimen: Topical steroids combined with preservative-free lubricants 3
Long-Term Prevention Strategy
UV protection is essential for preventing both primary pterygium development and postoperative recurrence, as UV radiation is the most important triggering factor in this multifactorial disease. 1, 2, 3
Common Pitfall to Avoid
Do not rely on lubricating drops as primary treatment for progressive pterygium—this delays definitive surgical intervention and allows continued growth that can cause irreversible corneal changes, irregular astigmatism, and visual compromise. 1, 2