Pterygium (Surfer's Eye) most often refers to a benign growth of the conjunctiva. A pterygium commonly grows from the nasal side of the sclera. It is usually present in the palpebral fissure. It is associated with and thought to be caused by ultraviolet-light exposure (e.g., sunlight), low humidity, and dust.
The predominance of pterygia on the nasal side is possibly a result of the sun's rays passing laterally through the cornea, where it undergoes refraction and becomes focused on the limbic area. Sunlight passes unobstructed from the lateral side of the eye, focusing on the medial limbus after passing through the cornea. On the contralateral (medial) side, however, the shadow of the nose medially reduces the intensity of sunlight focused on the lateral/temporal limbus.
Most pterygia are visually harmless and pose more of a nuisance rather than a disability.
The common surgical indications for pterygium excision include decrease in visual acuity, chronic irritation not responsive to medical ophthalmic therapy, obstruction in visual pathway, and cosmesis for employment.
Surgical techniques vary mainly due to the high incidence of recurrence. We currently advocate the performance of pterygium excision with intraoperative mitomycin-C and conjunctivoplasty with a conjunctival sliding flap.