Surfer's Eye (Pterygium): Symptoms, Causes and Treatment

Surfer's eye is the everyday name for a pterygium (tuh-RIJ-ee-um), a growth that extends from the white of the eye onto the cornea, the clear tissue that covers the iris and pupil. It is associated with long-term sun exposure, and time on the water adds to the dose, because water, sand and snow reflect UV light. A pterygium can make the eye red and irritated, and it can blur vision by causing astigmatism. Lubricating drops ease the symptoms; surgery removes the growth, but because a pterygium can grow back, surgery is usually kept for serious cases. Sunglasses that block UV and a hat with a brim are the main protection. If you see a growth on the white of your eye, an exam confirms what it is and gives a baseline for tracking a pterygium.

Key takeaways

Surfer's eye, or pterygium, is a whitish or pinkish growth from the white of the eye onto the cornea, the clear front layer, and it can blur vision.
Sunglasses blocking 99 to 100 percent of UVA and UVB light plus a brimmed hat are the main protection, since surfer's eye is associated with long-term sun exposure.
Lubricating drops ease redness and irritation, while surgery, which removes the growth, is usually kept for serious cases because a pterygium can grow back.
A painful eye, or light that suddenly bothers you, needs a same-day visit, or an emergency room when the office is closed.

What is surfer's eye?

Surfer's eye is a pterygium: an abnormal growth of tissue on the conjunctiva, the clear membrane that covers the white of the eye, and on the cornea next to it. The cornea is the clear outer layer at the front of the eye, and it helps your eye focus light.

In the mirror, a pterygium looks like a whitish or pinkish growth on the front of the eye. It can form in one eye or both.

You don't have to surf to get one: pterygium is most common in tropical regions.

What causes surfer's eye?

AOA describes pterygium as associated with chronic exposure to the sun's ultraviolet (UV) light, and its UV guidance says that the longer the eyes are exposed to solar radiation, the greater the risk of pterygium, cataracts, eye cancer and macular degeneration later in life.

On the water, UV reaches your eyes from above and is reflected back up from the surface. Activities near water, sand and snow increase UV exposure because those surfaces reflect light, and some surfaces reflect much of the UV that reaches them.

Clouds don't block all of it. The UV index can be high even on cloudy days, and the FDA warns that you can still damage your skin and eyes under cloud cover.

Some medicines, including certain antibiotics and birth control pills, may make your skin and eyes more sensitive to UV.

What are the symptoms of surfer's eye?

The American Optometric Association lists these:

Redness and irritation
A whitish or pinkish growth covering the front of the eye
A change in how the eye looks
Blurry vision, when the growth causes astigmatism

Astigmatism is a common vision condition that causes blurred vision, and it happens when the cornea is irregularly shaped. A pterygium growing onto the cornea can cause it. If your glasses prescription keeps changing, or one eye has become blurrier, mention the growth at your exam. Our page on astigmatism explains how it is corrected.

Is it surfer's eye or a pinguecula?

A pinguecula (pin-GWEK-yoo-luh) is a related growth that sits on the white of the eye. AOA describes it as a yellowish raised growth on the conjunctiva, typically next to the border where the colored part of the eye meets the white, and usually on the side closer to the nose. The National Eye Institute calls it a protein and fat deposit in the white part of the eye.

Long-term sun exposure is thought to be the most common reason for a pinguecula too. The difference is the cornea: a pterygium grows onto it, and a pinguecula stays on the white.

Feature	Pinguecula	Pterygium (surfer's eye)
Where it grows	On the white of the eye, beside the cornea	From the white of the eye onto the cornea
Color	Yellowish	Whitish or pinkish
Linked to	Long-term sun (UV) exposure	Long-term sun (UV) exposure
Effect on the eye	Irritation; in rare cases it affects how tears cover the eye	Redness and irritation; it can cause astigmatism and blur
Treatment	Artificial tears, gels or ointments; steroid drops in more severe cases	Artificial tears, gels or ointments; surgery in serious cases

Our pinguecula guide covers flare-ups and how we calm them.

How is surfer's eye treated?

Treatment starts with lubrication: artificial tears, gels or ointments for the redness and irritation.

Surgery is the way to remove the growth. Because a pterygium can grow back after surgery, AOA says surgery is usually only considered in serious cases.

In our practice, we recommend surgery when a pterygium keeps advancing toward the pupil, distorts vision or stays inflamed. We don't perform surgery ourselves: a surgeon removes the pterygium, and we co-manage your care before and after.

How can surfers protect their eyes from UV?

The National Eye Institute calls sunglasses and a hat the simplest and safest way to protect your eyes from UV rays. Look for:

Lenses that block 99 to 100 percent of UVA and UVB light, or carry a UV400 rating. By law, retailers must state the level of UV protection.
A good fit, which cuts the light that gets in around the top, bottom and sides of the lenses. AOA suggests wraparound frames if you spend a lot of time outdoors in bright sun.
A hat with a broad, dark brim that shades your eyes.
Polarized lenses if glare off the water bothers you. NEI notes they're good for reducing glare from snow or water.
A UV-protective coating on prescription glasses, which could be a wraparound design.

Out in the surf, sunglasses may not stay on. NEI suggests wraparound sunglasses or goggles to protect against intense light, and a brimmed hat helps whenever you can wear one. AOA reminds parents to protect children and teenagers too.

Our guide to UV protection and sunglasses explains what to look for on a label, and our optical makes sunglasses in your prescription.

When should you see an eye doctor about surfer's eye?

Book an exam if you notice a growth on the white of your eye, if one you already have is getting bigger or creeping toward the pupil, or if your vision is getting blurrier. A comprehensive eye exam checks the cornea, lens and lids along with the growth.

Some symptoms can't wait for a routine visit. A painful eye, or light that suddenly bothers you, needs a same-day visit, as our eye symptom guide explains: call us at 310-828-2010, or go to an emergency room when we're closed.

If sand or grit gets stuck in your eye after a session, don't rub it. During office hours (Monday 10 to 5, Tuesday through Friday 8 to 5), call us at 310-828-2010 and come straight in; we remove these in the office. When we're closed, go to an emergency room.

If a board or fin hits your eye and it hurts or your vision has changed, call us right away for a same-day exam, or go to an emergency room when we're closed. For sudden loss of vision in one or both eyes, even if it comes back, call 911. Our urgent eye care page explains how same-day visits work.

How we care for surfer's eye at Cohenmehr Optometry

Our optometrists in Los Angeles photograph and measure a pterygium at your exam, so each later visit can show whether it's growing.

If surgery becomes the right step, we do the candidacy work-up and corneal maps first and share the records and measurements directly with the surgical team. Afterward, your drop schedule, comfort checks and surface care run through our office.

Every plan includes UV-blocking sunwear and lubrication, before and after any surgery, and our optical can make prescription sunglasses.

Questions patients ask

Does a pterygium go away?

Drops won't make it disappear. Artificial tears, gels and ointments help with the redness and irritation, and surgery is the treatment that removes the growth. Even then, a pterygium can grow back after surgery, which is why surgery is usually only considered in serious cases. If yours is small and quiet, we photograph it at each exam to see whether it is changing.

Can you use redness-relief eye drops for a pterygium?

They relieve redness but don't treat the growth. Lumify (brimonidine tartrate 0.025%), for example, is labeled to relieve redness of the eye due to minor eye irritations, and its label says to stop and ask a doctor if you have eye pain or changes in vision, if redness or irritation continues, or if the condition worsens or lasts more than 3 days. A pterygium can keep irritating the eye, so redness that keeps coming back is a reason to have it examined.

Are polarized sunglasses UV protected?

Check the label for both, because polarization and UV blocking do different jobs. Polarized lenses are good for reducing glare from snow or water. UV protection is listed on its own: look for lenses that block 99 to 100 percent of UVA and UVB light, or that are marked UV400. Retailers are required by law to state the level of UV protection, so it should be on the tag or label.

Can the sun cause cataracts?

Time in the sun is one of the risk factors. A cataract is a cloudy area in the lens of the eye, and the National Eye Institute lists having spent a lot of time in the sun among the risks, along with smoking, diabetes, a family history of cataracts and taking steroids. NEI's advice matches the advice for surfer's eye: wear sunglasses and a hat with a brim. Our cataracts page covers the signs and when surgery makes sense.

Sources

Written by

Dr. Kevin Cohenmehr, OD

Medical eye care: glaucoma, diabetic eye exams, macular degeneration and eye infections, plus vision therapy for children. A graduate of UCLA and SUNY College of Optometry.

About Dr. Kevin →

Surfer's Eye (Pterygium): Symptoms, Causes and How to Protect Your Eyes