By Dr. Jin Kim
Have you ever heard of surfer’s eye? If you’re from Atlanta, you probably call it wake surfer’s eye from spending too much time on the water at Lake Lanier, but surfer’s eye is actually called pterygium, and a major contributing factor is exposure to UV light that’s reflected from the surface of the water. Let’s take a look at what pterygium is and the types of treatments that are available at Thomas Eye Group in Atlanta, GA.
Just because you spend your weekdays hanging ten on your accelerator during the I-85 rush, it doesn’t mean that you’re immune to getting surfer’s eye. If you spend a lot of time swimming laps in outdoor pools or hanging out at the lake, you could be at risk. This is because UV light exposure, including UV light that’s reflected from surfaces, is a risk factor.
Pterygium is a long-term eye ailment that doesn’t go away on its own. The condition is characterized by an abnormal growth of cells or tissue on the conjunctiva, which is the translucent membrane that covers the sclera (white part of the eye). When it begins and is isolated to the sclera, it is known as a pinguecula, however as it reaches the cornea, it becomes a pterygium. The growth typically appears white or pink, and it is usually non-cancerous.
The amount of reflected UV light that hits your eyes depends on what’s around you. When you’re standing on concrete or asphalt, you can expect 10 percent of the UV light to be reflected. Grass also reflects about 10 percent of the UV light that shines on it. However, if you love to surf or swim, you might be surprised to find out that sand reflects between 10 and 25 percent of the UV light that hits it, and water reflects between 10 and 20 percent of the UV light that hits it. This means that if you spend a lot of time on the water or beach, the reflected light that can hit your eyes is almost doubled when compared to grass, concrete or asphalt, which increases your risk of developing pterygium or surfer’s eye. Additionally, if you’ve ever had photokeratitis, which is essentially a sunburn of the eye, you may be at a higher risk for developing pterygium.
Pterygium is a long-term eye ailment that doesn’t go away on its own. The condition is characterized by an abnormal growth of cells or tissue on the conjunctiva, which is the translucent membrane that covers the sclera (white part of the eye). When it begins and is isolated to the sclera, it is known as a pinguecula, however as it reaches the cornea, it becomes a pterygium. The growth typically appears white or pink, and it is usually non-cancerous.
The exact number of individuals with surfer’s eye and/or photokeratitis in Georgia is unknown. In fact, instances of photokeratitis are especially difficult to track because the individuals rarely seek medical help. This is because photokeratitis usually heals on its own after about three days.
However, it’s estimated that between 10 million and 15 million people have surfer’s eye. It’s more prevalent in coastal locations and where people spend a lot of time on the water. However, just because Atlanta, GA is landlocked doesn’t mean that pterygium isn’t a possibility. Individuals who spend a lot of time surfing, swimming laps, water skiing or participating in other water sports are at risk for surfer’s eye if they don’t take some precautions.
Surfer’s eye, or pterygium, doesn’t really care if you’re swimming laps at your local community pool, wakeboarding in a lake or surfing out on the ocean. It cares about how long you’re exposing your eyes to UV light, the amount of UV light that is reflected into your eyes and if you have eye irritation.
For example, if you’re swimming in your community pool from the hours of 10 AM until 4 PM, that’s when the UV light tends to be the strongest. You’re also exposing your eyes to chlorinated water, which can cause eye redness and inflammation, and if it’s windy, the wind could be drying out your eyes, which also causes eye irritation. When extended UV light exposure is combined with eye irritation, the risk of developing pterygium increases.
This UV exposure will initially form a pinguecula on the sclera of the eye, the precursor to a pterygium. Once the pinguecula grows and reaches the cornea, it has fully transitioned into a pterygium or surfer’s eye.
Surfer’s eye is not typically cancerous. However, it’s not a purely cosmetic problem either. Pterygium can be irritating. It can affect how your eye looks, and it can cause vision problems. Individuals with surfer’s eye often state that they have eye redness, irritation, dry eye symptoms, and a feeling like there is something stuck in their eye. Some people even complain of burning sensations. Aside from the uncomfortable symptoms, as the pterygium grows into the cornea, it affects its shape and causing vision changes.
Lastly, if the condition isn’t treated, especially after it’s infiltrated the cornea and caused vision changes, it can lead to permanent vision loss. Therefore, if you have symptoms of surfer’s eye or notice changes in your vision, you should schedule an appointment with one of our eye doctors at Thomas Eye Group, serving Atlanta.
When you’re out on the water, you should make sure that your sunglasses are safe for watersports. Of course, that term can be a little vague. To ensure your eyes are protected, consider purchasing sunglasses with larger lenses that are listed as UV400. UV blocking sunglasses with large lenses protect your eyes and the skin around your eyes. You might also consider getting polarized sunglasses with side shields or wraparound sunglasses to protect the sides of your eyes.
Additionally, frames with rubber nose pads and temple tips slip less than frames without those features. At Thomas Eye Group, we sell sunglasses frames in our optics department. This means that you can try on the frames, order your prescription lenses, and get recommendations and advice from our team of eye care professionals in Atlanta.
If you have a pterygium growth on your eye, there are treatments available at Thomas Eye Clinic. Our ophthalmologists, Dr. Robert Tucker and Dr. David Sackel, can examine your eyes and determine the best course of treatment. Dr. David Sackel is a cornea specialist and comprehensive ophthalmologist. He performs corneal transplants, as well as LASIK and cataract surgery. Dr. Robert Tucker is an anterior segment specialist, as well as a comprehensive ophthalmologist, and one of his specialties is corneal pterygium excision.
Of course, if you have surfer’s eye, you may not need surgery. If the growth isn’t affecting your vision, lubricating eye drops may be enough to keep your eye comfortable. If you have redness or inflammation, our eye doctors may recommend steroid eye drops, and to help slow the growth of the pterygium, our ophthalmologists will recommend ways to limit the amount of UV light that your eyes are exposed to, like wearing a wide-brimmed hat and getting the right type of sunglasses or swimming goggles.
If you’d like your pterygium removed because it’s affecting your vision, threatening the health of your cornea, or simply for cosmetic purposes, it can be removed by our cornea specialists in Atlanta.
It’s important to note that the only way to get rid of a pterygium is to have it surgically removed, and getting a conjunctival autograft is one of the most successful types of surgeries. However, it’s important to note that pterygium surgery has a recurrence rate of between 2 percent and 33 percent, according to an article at the National Library of Medicine.
The conjunctival autograft procedure starts with numbing drops. These are placed into your eyes in order to prevent discomfort. The surgery site is prepared. Then, our eye surgeon will perform a pterygium excision, which is the removal of the growth from the conjunctiva and cornea, if it’s progressed into the cornea.
Once the tissue has been removed, the eye surgeon takes a conjunctival graft from a different part of the eye, usually from under the eyelid, and places that graft over the surgical site. The conjunctival graft is then secured with very thin stitches or a special type of glue called fibrin glue.
Conjunctival autograft is often preferred over bare sclera methods because it reduces the risk of the growth recurring. Bare sclera pterygium eye surgeries can have recurrence rates that are six to 25 times higher than the autograft method.
If you spend a lot of time out on the water swimming, wake surfing or boating, remember to schedule regular eye health visits, especially if you’ve noticed any changes to your vision or the appearance of your eyes. At Thomas Eye Group in Atlanta, we provide corneal health screenings, and if you need sunglasses or glasses, we offer complimentary fittings in our optical shop.
Jin Kim, O.D. is a board-licensed comprehensive optometrist. Dr. Kim offers comprehensive eye exams that cover various ocular conditions such as dry eyes, macular-degeneration, cataracts, and diabetic eye disease among others. He also provides post-operative care after refractive, cataract, and retina surgery.
