Pterygium and Chalazion Surgeries

Pterygium and Chalazion Surgeries

A pterygium refers to conjunctival growth or growth of the mucous membranes that covers the white part of the eye that lies over the cornea. Cornea is the clear covering that lies at the front of the eye. This noncancerous or benign growth is usually shaped in the form of a wedge. A Pterygium usually does not require treatment as it does not typically cause serious problems. However, it needs to be removed if it interferes with your vision.

The exact cause of pterygium is unknown. Excessive exposure to ultraviolet rays can lead to these growths. It is more common in people who live in warm climates and spend a significant amount of time in windy or sunny environments. Those whose eyes are exposed to certain elements everyday are at an increased risk of developing this condition. These elements include sand, pollen, wind, and smoke.

A pterygium does not always lead to symptoms. Its symptoms are usually mild. Common symptoms of pterygium include blurred vision, redness, and eye irritation. You might also feel an itchiness and a burning sensation. If a pterygium becomes big enough to cover the cornea, it can interfere with your vision. Larger or thicker pterygium can also make you feel like you have a foreign object in your eye. You may not be able to wear contact lenses due to discomfort if you have a pterygium.

A pterygium can cause severe scarring to the cornea. This is, however, rare. Corneal scarring needs to be treated as it can cause loss of vision. For minor cases, treatment involves treating the inflammation by applying ointment or eye drops. For more serious cases, treatment can involve surgical removal of the pterygium.

Diagnosing a pterygium is quite easy. Your ophthalmologist may diagnose it on the basis of a physical examination with a slit lamp. This allows the doctor to visualise your eye with the help of magnification and bright light. If additional tests are needed, those may include:

  • Visual acuity test
    It is a test that involves reading letters from an eye chart.
  • Corneal topography
    It is a medical mapping technique that is employed to measure the corneal curvature changes.
  • Photo documentation
    This procedure involves taking images so that growth rate of the Pterygium can be tracked.

Usually a pterygium does not need any treatment. If it is causing severe discomfort or blocking your vision, treatment is needed. Your ophthalmologist may want to check your eyes sometimes to determine if the growth is causing serious problems in vision.

Medications

If the pterygium is giving rise to a significant redness or irritation, your doctor may prescribe eye ointments or eye drops containing corticosteroids so that the inflammation is reduced.

Surgery

Surgery may be recommended to remove the pterygium if eye ointments or eye drops don’t provide relief. Surgery is also performed if a pterygium causes vision loss or a condition known as astigmatism, which can cause blurry vision. If you want the pterygium removed for cosmetic reasons, you can discuss the surgical procedures with your doctor.

Although those are minimal, there are some risks associated with these operations. In some cases, pterygium can come back after it has been surgically removed. You may also experience irritation and dryness in your eyes after surgery. Your doctor can, however, prescribe certain medications for you to reduce the risk of recurrence of a pterygium.

Try to avoid exposure to harsh environmental conditions that may give rise to a pterygium. You can help prevent the formation of a pterygium by shielding your eyes against wind, sunlight, and dust with the help of sunglasses. Your sunglasses should be good quality so that those provide you with protection against the ultraviolet rays of the sun. If you are already suffering from a pterygium, its growth can be slowed by limiting exposure to factors like dust, wind, smoke, pollen, and sunlight. By avoiding these factors, you can also prevent pterygiums from recurring if you have had those removed.

The surgery for pterygium is performed to remove the noncancerous conjunctival growths from the eye. The conjunctiva is the clear tissue that covers the eye and the inside of the eyelids. Some pterygium cases give rise to little or no symptoms. Severe conjunctival tissue overgrowth can cover the cornea and cause interference with the vision.

Presurgical procedures

Pterygium surgery is a minimally invasive procedure that takes around 30-45 minutes. Your ophthalmologist will provide you with some general guidelines so that you are prepared for the surgery. Before the procedure, you may be required to fast or eat a light meal. Apart from that, if you are someone who wears contact lens, you will be directed to stop wearing those for at least 24 hours before the procedure.

Because you will be given light sedation, healthcare providers will require you to arrange transportation post-surgery as you won’t be able to drive by yourself.

The surgical procedure for pterygium is quick and relatively low risk:

  • Your surgeon will first sedate you and numb your eyes so that you don’t face any discomfort during surgery. Then, they will clean the surrounding areas.
  • The surgeon will remove the pterygium with some associated conjunctival tissue.
  • After the pterygium is removed, the doctor will replace it with a graft of the connecting membrane tissue so that recurrent pterygium growths can be prevented.
  • After removal, the doctors will either use fibrin glue or sutures to secure the graft of the conjunctival tissue in its place. The possibility of recurrent pterygium is reduced by both techniques.

The bare sclera technique

Another option that doctors use is the bare sclera technique. It is a relatively more traditional procedure that your doctor uses to remove the pterygium tissue without replacing it with a tissue graft. Therefore, the underlying white of the eye is left exposed so that it can heal by itself.

Recovery

The doctor will apply an eye patch or pad on the operated eye at the end of the surgery to prevent infection and discomfort. You will be advised to not rub your eyes post-procedure to avoid dislodging the attached tissue.

Your doctor will give you proper aftercare instructions including medications, cleaning procedure, and follow-up appointments. Recovery can take anywhere from weeks to months. Your eyes will heal without any signs of discomfort or redness. Specific instructions may also depend on the type of surgery and technique used on you.

Complications

Just like with any surgical procedures, there are a few associated with pterygium surgery. After the surgery, it's ok to experience a mild degree of redness and discomfort. It is also common to experience a sensation of blurriness during the recovery period. However, if you start experiencing vision difficulties, a complete vision loss or notice that your pterygium is regrowing, you must schedule an appointment with your doctor.

Outlook

Although pterygium surgery is an effective procedure, your doctor might recommend ointments and prescriptions in mild cases. However, if these non-malignant growths start affecting your vision or quality of life, the next step will have to be surgery.

Chalazion

A chalazion refers to a red bump on the eyelid. Sometimes, it is referred to as an eyelid cyst or a meibomian cyst. It develops slowly when an oil gland called meibomian gland gets clogged or obstructed. A chalazion may be painful in the beginning. However, after some time, it is not painful. It usually develops on the upper eyelids but may sometimes involve the lower eyelid also.

Typically, a chalazion develops in adults who are aged anywhere between 30 to 50 years. They are rare in children but can occur sometimes.

A chalazion is different from a stye, however, it can develop secondary to a stye. A stye is a bacterial infection that causes swelling of the gland. It can sometimes be painful but chalazion is usually not a painful condition and develops further back on the eyelid.

A chalazion may occur when something obstructs a small eyelid oil gland - the glands that keep the eye moist. An obstructed gland starts retaining oil and swells up. The fluid will eventually drain and you may develop a hard lump on your eyelid.

Following are some additions causes of chalazion:

  • Chronic blepharitis, eyelid inflammation (swelling, redness, and irritation).
  • Rosacea (a skin condition that causes redness and acne).
  • Tuberculosis (TB).
  • Seborrheic dermatitis (red, dry, flaky and itchy skin).
  • Viral infections.

Following are some of the symptoms of a chalazion:

  • Mild irritation, causing your eyes to water.
  • Painless bump in your eyelid, usually on the upper eyelid.
  • Blurred vision from larger chalazia that push on the eyeball.

If you have a chalazion, you will need to see an ophthalmologist or an eye specialist. These healthcare providers will examine your condition and offer treatment plans. When seeing an ophthalmologist, you should expect:

  • External eye examination
    Your doctor will examine your eyelids, eyes, eyelashes, and the texture of the surrounding skin.
  • Health history
    You will be asked complete health history. The information will help your doctor determine underlying problems that could contribute to the formation of a chalazion.
  • Thorough eyelid examination
    Your healthcare provider will shine a bright line at your eye and use magnification to visualise the base of your eyelashes. They may also look at the openings of the eyelid glands.

Most cases of chalazion are treated conservatively as those go away in a month or so. You must never try to pop on a chalazion of push on it. It can also cause eye injury. You can instead try home treatments, including:

  • Warm compresses
    Soak a clean piece of cloth in warm water and hold it over the affected eye for about fifteen minutes. Repeat this for 2-3 times a dry to facilitate the opening of the blocked eye gland.
  • Massage
    Massage the affected eyelid gently a few times a day. Make sure to massage for a few minutes every day with light to medium pressure. Gentle massage helps open up blocked eye glands.
  • Good hygiene
    Avoid wearing eye makeup while you have a chalazion and keep the area clean after the chalazion drains. Follow healthy eye hygiene practices and try not to touch your eyes.

If the chalazion does not improve, you must seen an ophthalmologist and seek expert medical care and attention. If you are located in Indore, you can visit the Department of Ophthalmology at Kokilaben Dhirubhai Ambani Hospital, Indore and seek an appointment with an eye specialist who will guide you to the next step. The fluid inside the chalazion may need to have drained through a small incision. You may also require to have a steriod injection so that the swelling and inflammation is reduced. Seek the best chalazion treatment at our hospital in Indore.

Even though the surgery for chalazion is not considered as a major procedure, it doesn’t involve anaesthesia. Depending on your age, health needs, health history, you may be given a local anaesthesia affecting only the area around the eye or a general anaesthesia that completely puts you to sleep for the procedure. Before the procedure, make sure to let your healthcare provider know about any medications you are currently taking, including prescription medications, over-the-counter (OTC) medications, herbal remedies, and vitamins and supplements.

Make sure to mention any health conditions that you have, especially you have sleep apnea or you snore a lot. Both of these problems may increase your susceptibility to experience certain side effects of anaesthesia. You should also let them know if you have had an adverse reaction to anesthesia in the past.

You will be provided with additional information regarding how to prepare for the surgery, including whether you can drink or eat before it.

The surgery will be performed in the hospital and before it, you will be given anaesthesia so that you won’t feel any pain before the procedure. After the anaesthesia has shown its effect, the following steps are performed by the surgeon:

  • The surgeon uses a clamp to keep your eye open
  • Then, he makes a small incision on your outer eyelid (for a larger chalazion) or inner eyelid (for a smaller one) and scraps out the contents of the chalazion
  • After that, he closes the incision with dissolvable stitches

If you get recurrent chalazions, the doctor may follow up by performing a biopsy on the contents of the chalazion to investigate about the potential underlying causes.

The whole procedure takes around ten minutes, however, the entire process including the preparation and induction and reversal of anaesthesia takes around forty five minutes.

You will be prescribed some antibiotics after the surgery. You might also be given a steroid ointment in some cases. Make sure to follow your doctor’s prescription carefully as those will help the site from getting infected and treat post-surgical inflammation. You may also be given an eye patch or eye pads to keep your eyes protected. If you notice any swelling or bruising around the eye, don’t be alarmed. It is also normal for the surgical site to leak a reddish fluid for a few days post-procedure.

After the surgery, you can use a cold compress on your eyes for a few hours so that swelling is reduced.

After the surgery, try applying moist heat to the site for a day. You will even be given detailed information about how to do this if you require it. Applying moist heat on the surgical site thrice a day can help with drainage of the wound and reduce the chances of recurrence of the chalazion.

After the surgery, you must avoid:

  • wearing contact lenses for a week
  • rubbing or touching your eyes
  • swimming
  • getting water in your eyes when showering
  • wearing makeup for one month.

It takes around 7-10 days for the surgical incision to completely heal. It is a great idea to avoid performing any activities that could cause eye injury for around two weeks. Keep applying moist heat to your eyes thrice a week for about ten minutes at a time as you heal. Keep doing this for a few days post-surgery. You should also avoid wearing contact lenses for about a week after the surgery and don’t wear eye makeup for up to a month after surgery.

Your chalazion may need to be surgically removed if it doesn’t go away on its own. This is a safe and relatively quick procedure. Ensure that your follow the aftercare instructions of your healthcare provider to avoid developing complications.

The Department of Ophthalmology at Kokilaben Dhirubhai Ambani Hospital, Indore offers primary ophthalmological care services, including ophthalmologic checkups and routine and emergency medical and surgical management of a vast range of ophthalmological conditions. Annual ophthalmological exams, consultation for eyeglasses, and referrals for fitting contact lenses are also offered. Meet the best eye surgeons in Indore at our hospital for advanced eye procedures.

Comprehensive diagnostic services available include assessment of refractive errors, visual acuity, slit lamp evaluation, tonometry, ophthalmoscopy, gonioscopy, pachymetry, visual field testing, and fundus photography. The typical disorders diagnosed and treated in the department include contact-lens-related problems, blepharitis and dry eye, corneal ulcers, pterygium, herpes zoster and herpes simplex infections, allergic conjunctivitis, cataract, diabetes, glaucoma, macular degeneration, refractive errors like myopia, hypermetropia, and astigmatism, and ocular trauma. Consult the best ophthalmologists in Indore who have years of experience in the field and are equipped with the latest state-of-the-art technology and ophthalmologic instruments.