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While the skin risks of ultraviolet (UV) radiation get a lot of attention, exposure to UV rays can also lead to an eye condition called pterygium, which is commonly referred to as "surfer's eye."

Matthew Gorski, MD, an ophthalmologist at Northwell Health in Great Neck, New York, told MedPage Today that he sees multiple patients with pterygium every single day -- and the vast majority are not surfers but have other exposure risk factors.

"A pterygium is a very common fleshy growth of the cornea and conjunctiva. Some people call it 'surfer's eye,' although it can certainly happen in patients who are not surfers," Gorski said, noting that people who are exposed to a lot of UV radiation are most at risk. This includes people who spend a lot of time outside as well as people who live close to the equator, where UV rays are stronger.

"Growth usually begins on the conjunctiva, and then you get this fibrovascular development -- so blood vessels and fibers grow -- and it can grow from the conjunctiva onto the cornea," he explained.

Wearing sunglasses with UV protection is critical to preventing pterygium formation and growth, Gorski said. Cheap sunglasses with questionable UV protection proliferate on sites like Temu and Amazon, but Gorski encouraged purchasing eyewear from reputable vendors to ensure maximum UV protection. He noted that keeping the eyes lubricated can also help, because a dry ocular surface can promote the growth of pterygia.

Patients with a pterygium often present to the office with a red inflamed eye and may complain of irritation or a foreign body sensation. If the pterygium has grown significantly, the patient might notice a white spot on the eye. Pterygia can also become raised, which contributes to the scratchy, irritated feeling. Gorski noted that pterygia does not start in the central visual axis, but they can eventually grow to affect the vision.

Treating a pterygium starts conservatively with lubrication from artificial tears and topical anti-inflammatory drops. But at a certain point, surgery is the only way to totally get rid of the growth. Researchers are actively exploring ways to shrink pterygia without surgery, like medicated eye drops, but there are no FDA approved drugs to treat the condition.

"If [the pterygium] starts to be persistently red, inflamed, and bothersome, or if it starts to grow towards your central cornea where it's starting to affect the vision, that's when we recommend surgical removal," Gorski said.

He described the removal surgery as low-risk; patients are in and out the same day, though full recovery takes a few weeks.

"We delicately peel the growth off the surface of the eye, and then there's a variety of different techniques we use to cover the area where the pterygium used to be," he explained.

One method is conjunctival autograft, which uses a piece of conjunctiva tissue from behind the eyelid to patch the hole. This method still leaves a wound on the eye, but in a better protected area. Another method is amniotic tissue graft, which uses donated amniotic membrane tissue from a placenta to act as a sort of bandage while the eye heals. This technique is especially helpful for pterygia too large for autografting, according to .

Pterygia are benign; but as a safeguard, the surgically removed growths are sent to pathology for testing to ensure they're not cancerous.

Cancerous growths "can sometimes mimic a pterygium, so a thorough clinical evaluation is important," Gorski said.

Part of this evaluation is assessing the mobility of the lesion, as well as looking for any irregular pigmentation or irregular blood vessels. Conjunctival lissamine green might be used to stain the ocular surface to look for these signs that may indicate malignancy.

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