hiya wa howa aswat

Words by surfer and medical professional, Dr David Baglow.

What Is it?

The eye has a layer of tissue covering it called the conjunctiva. Surfing exposes eyes to the correct conditions for the conjunctiva to get repeatedly irritated and inflamed. This regular irritation and inflammation causes the conjunctiva to lose control of its ability to repair and it starts to develop an extra layer of tissue which is essentially scar tissue. This new layer of tissue has the catchy name, Pterygium, with a silent P (in Greek Pterygium means wing). This is because the new tissue that grows on the surface of the eye is shaped like a wing. Apparently.

What causes it?

Irritation to the conjunctiva comes in many forms:
-Exposure to changing atmospheric humidity. Moving from dry air conditioning to high humidity outside doesn’t help. 
-Sunlight. This is often incorrectly described as the biggest risk factor for developing surfer’s eye. It’s the biggest acquired risk factor. Having a genetic predisposition is now thought to be the biggest risk factor. Clearly the reflection of the sunlight of the water increases the intensity of ultra-violet exposure by the conjunctiva. Interestingly it’s a lot more common on the side of the eye nearest the nose. This has been thought to be due to reflection of sunlight by the nose. More recently its been thought that it’s due to the ability of sunlight to shine through the cornea ‘sideways on’ from the side of the head and cause irritation to the conjunctiva as its travels through the cornea and is refracted towards the conjunctiva.
-Being male. Men are twice as likely to develop surfer’s eye than women.
-Sea water
-Sea spray
-Dust/dirt
-Sand exposure

What are the symptoms?

Often well tolerated, if you don’t mind looking like a Salty dog! Cosmetic is sometimes the only complaint. Some people complain of having the feeling of having tired eyes, or the feeling of having something in your eye. Other complaints include:
-More frequent episodes of eye irritation
-More frequent episodes of conjunctivitis (infection of eye).
-Very rarely effects vision. It has to grow a long way to start bothering the pupil. 

Is it dangerous?

No.

What can I do to stop it?

-Don’t go in the sun or sea.
-Wear sunglasses or goggles in the sea. 
-Wear decent glasses on land. 
-Avoid shorebreaks like the plague. 

What is the treatment?

Surgery is the only treatment. It can grow back in 20% of cases. Fake tears such as ‘lacrilube’ may help. There have been trials using preparations of ‘anti-growthfactor’ with variable results.