Recent study shows increased risk of melanoma for people with pterygia

Just recently there was a paper published in the British Journal of Ophthalmology by researchers from the Lions Eye Institute (LEI) in Perth which showed that the presence of a pterygium indicates a significantly increased risk of developing a cutaneous melanoma.  Not surprisingly, the authors of the study recommended that eye care providers who see patients with developing pterygia should advise these patients of this increased risk and recommend regular skin surveillance, especially since early detection of melanoma can save lives.

A pterygium is a triangular formation of fibrovascular tissue which extends from the bulbar conjunctiva onto the cornea, usually on the nasal side.  Pterygia are more commonly seen in tropical climates, thus implicating sunlight and/or UV radiation as a probable cause.  Not surprisingly, Australia has a relatively high incidence of pterygia (about 1%) – especially in rural areas – with this incidence increasing to over 10% in men over the age of 60.

The development of a pterygium onto the cornea can lead to both significant corneal distortion and the development of large amounts of corneal astigmatism, with a subsequent decrease in visual acuity.  In 2001, my good friend and colleague Laurie Sullivan and I published a case report in Clinical and Experimental Optometry about a patient who presented with an advanced pterygium and a large degree of corneal astigmatism induced by the encroachment of the pterygium onto the cornea.  Subsequent surgical removal of the lesion by Laurie brought about a reversal of the pterygium-induced corneal astigmatism.  A copy of this paper can be found at 

One of the co-authors of this paper which showed a possible link between pterygia and melanoma was Professor David Mackey.  David – who has achieved international recognition as a genetic ophthalmologist – is Managing Director of the LEI and Professor of Ophthalmology and Director of the Centre of Ophthalmology and Vision Science at the University of Western Australia.  He is also a very nice guy and I had the pleasure of working with him many years ago when we both worked as volunteers in the Eye Clinic in the Sydney 2000 Olympic Games Village Polyclinic.