Frequently Asked Questions
Honest answers to the questions patients most commonly ask about their pterygium, the signature no-stitch pterygium surgery technique, and what to expect before and after surgery.
ABOUT YOUR PTERYGIUM
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A pterygium is a benign (non-cancerous) growth of fibrovascular tissue that originates from the conjunctiva — the thin membrane covering the white of the eye — and extends onto the cornea, the clear front surface. It typically appears as a fleshy, wedge-shaped or triangular lesion growing inward from the inner corner of the eye.
Despite the common nickname "surfer's eye," pterygiums affect anyone with cumulative UV, wind, and dust exposure. Queensland has among the highest pterygium rates in the world due to year-round UV intensity and an outdoor-oriented population.
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A pterygium is not cancerous, but it is not benign in terms of consequences. Left untreated, a growing pterygium can:
Distort the corneal surface, inducing irregular astigmatism and blurred vision
Encroach on the visual axis, directly blocking vision
Cause chronic dryness, redness, and irritation
Interfere with contact lens wear and refractive surgery planning
The impact on daily life and vision is proportional to its size and rate of growth — which is why monitoring and timely intervention matter.
Rarely, a pterygium may mimic a type of skin cancer that grows on the surface of the eye. Ocular surface squamous neoplasia (OSSN) can occasionally be indistinguishable from a pterygium. Because of this, laboratory analysis of any pterygium that is removed should be performed to ensure it is not cancerous.
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The primary driver is chronic UV radiation exposure, particularly UV-B. Wind, dust, dry conditions, and low humidity are significant contributing factors — explaining why pterygiums are disproportionately common in Queensland, rural and coastal Australia, and among those who spend substantial time outdoors.
There is also a genetic predisposition; some individuals develop pterygiums despite moderate sun exposure, while others remain unaffected despite decades outdoors. Once established, pterygiums tend to grow slowly but can accelerate during periods of sustained UV exposure.
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Eye drops — typically lubricant or artificial tear preparations — can reduce the symptoms associated with a pterygium, particularly dryness and irritation. They can also reduce redness temporarily. However, they do not stop or slow the growth of the pterygium, and they do not treat the underlying condition. Steroid drops can reduce inflammation within a pterygium which can reduce the prominence of smaller lesions.
If your pterygium is symptomatic and growing, drops are a temporising measure, not a solution. Surgery is the only way to definitively remove the growth.
UV-protective wraparound sunglasses and wide-brimmed hats are the most effective non-surgical measure to slow pterygium progression.
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There is no single universal threshold — the decision to operate is individualised. Generally, surgery is recommended when:
The pterygium is causing significant, persistent symptoms not controlled by lubricants
It is visually significant — either approaching or encroaching on the visual axis
It is inducing corneal astigmatism that affects best-corrected vision
It is cosmetically distressing to the patient
Laser vision correction or other ocular surgery is being planned and the pterygium must be addressed first
Dr. Hayes will assess your specific case at consultation and provide an honest recommendation based on the pterygium's size, location, rate of progression, and your symptoms and goals.
You can also gauge how badly your pterygium symptoms are affecting you by taking a free online quiz at https://www.thevisionsurgeon.au/eye-health-quizzes/
THE SURGERY
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The surgery itself is not painful. The eye is completely anaesthetised with local anaesthetic drops and an injection around the eye prior to the procedure. Intravenous sedation is also used to keep you relaxed and comfortable - a twilight anaesthetic. Most patients are pleasantly surprised by how stress-free the experience is.
In the 24–48 hours following surgery, some discomfort is possible — typically a gritty, scratchy sensation. This is well-managed with lubricant drops, prescribed anti-inflammatory drops, and standard oral analgesia if needed. The absence of sutures in Dr. Hayes's technique significantly reduces the postoperative irritation compared to traditional sutured approaches.
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The surgical procedure itself typically takes 20-30 minutes. You should plan to be at the day surgery facility for approximately 2–3 hours in total, accounting for pre-operative preparation, the surgery, and a period of post-operative monitoring before discharge.
You will need someone to drive you home. You are not able to drive yourself on the day of surgery.
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You are not fully awake, the surgery is performed under twilight sedation meaning you remain deeply relaxed, drowsy state throughout. However, you are not so deep under anaesthetic that you stop breathing and require breathing tubes. You remain breathing on your own as general anaesthetic is not routinely required for pterygium surgery and is generally reserved for specific cases where it is clinically indicated.
You will not see the surgery, and you will not feel it. The local anaesthetic prevents any sensation in the eye.
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Bilateral simultaneous pterygium surgery (both eyes in one sitting) is generally not performed. The primary reason is patient safety and practicality — having both eyes patched or impaired simultaneously would leave you unable to function safely at home during the immediate recovery period.
If you have pterygiums in both eyes, Dr. Hayes will typically recommend treating the more symptomatic or visually significant eye first, then scheduling the second eye once the first has adequately recovered — generally only a matter of weeks later.
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Monitoring is entirely appropriate if the pterygium is small, not growing rapidly, and not causing significant symptoms or visual compromise. Many patients are in a watch-and-wait phase for some time before intervention.
However, it is important to understand that pterygiums do not resolve spontaneously — they only grow. And while early surgical removal is straightforward, advanced pterygiums that have grown significantly onto the cornea are more complex to remove and carry a greater risk of residual corneal scarring affecting vision. Early intervention is generally preferable to waiting until the pterygium is very large.
THE SIGNATURE NO-STITCH TECHNIQUE
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In conventional conjunctival autograft pterygium surgery, the graft of tissue taken from beneath the upper eyelid is secured to the surgical site using fine sutures — stitches. These sutures remain in the eye for weeks to months and are a common source of post-operative irritation, inflammation, and discomfort.
In Dr. Hayes's Signature No-Stitch technique, the conjunctival autograft is secured instead using fibrin tissue glue — a biological adhesive derived from blood-clotting proteins. The glue holds the graft securely in place while it adheres naturally to the underlying tissue, after which the glue is no longer needed. No sutures are left in the eye. No sutures need to be removed.
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Yes. The fibrin glue holds the graft securely during the critical early healing period — typically the first 24–72 hours — after which the graft begins to adhere via natural biological adhesion to the underlying tissue. By the time the glue has fully absorbed (within days), the graft is well secured by the patient's own healing response.
Multiple randomised controlled trials and large case series have demonstrated that fibrin glue autograft fixation produces equivalent or superior graft stability compared to sutures, with the added benefits of reduced inflammation, faster healing, and better patient comfort.
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Compared to conventional sutured autograft surgery, the no-stitch technique offers:
Less postoperative discomfort — no suture ends abrading the eyelid or ocular surface
Reduced inflammation — sutures are a foreign body stimulus; fibrin glue is biologically compatible
Faster graft adhesion — the graft integrates more evenly and naturally without suture tension distorting tissue
Better cosmetic outcome — no suture track marks or localised scarring patterns
Faster visual recovery — less surface disruption translates to clearer vision sooner
No suture removal appointment — the patient experience after discharge is simpler
The tradeoff is surgical complexity: placing a well-positioned, tension-free graft secured with glue demands a high level of skill and precision. It is a technique that rewards experience.
RECOVERY & AFTERCARE
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Most patients return to desk-based or sedentary work within 3–5 days of surgery, once initial discomfort has settled and vision has stabilised sufficiently for computer use.
For work involving physical labour, exposure to dust or wind, or environments where eye protection is difficult to maintain, a longer absence — typically 1–2 weeks — is recommended. Dr. Hayes will give you specific guidance based on your work environment at your pre-operative consultation. Niche professions with high risk of contamination may even require longer off to reduce infection risk.
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You cannot drive on the day of surgery due to the sedation. You must arrange for someone to take you home. Most patients are able to resume driving within a few days once comfort and vision are adequate, though this will be confirmed at your first review. Even once cleared to drive, do not drive until you feel confident your vision and reaction time are not impaired.
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Swimming — in pools, the ocean, or any body of water — should be avoided for a minimum of four weeks following surgery to prevent infection and graft disruption.
Light, non-contact exercise (walking, light cycling) can generally resume as soon as you feel ready, provided there is no significant sweating near the eye and the eye is protected from dust and wind. Anything involving risk of impact to the eye should be deferred until cleared — typically at the one-month review.
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Redness is expected and is a normal part of the healing process. The eye is typically red and inflamed in the first 1–2 weeks. By weeks 3–4, redness begins to noticeably improve though a small amount often remains. The final cosmetic result — including the clarity of the white of the eye — is typically achieved between 8 weeks and 3 months post-operatively.
The no-stitch technique generally produces a faster-clearing, natural-looking final cosmetic result.
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You will be prescribed a specific post-operative drop regimen at discharge. This typically includes:
An antibiotic ointment for the first 2 weeks to prevent infection
An anti-inflammatory steroid drop tapered over a few months to manage post-operative inflammation and reduce recurrence risk
Frequent lubricant or preservative-free artificial tear drops throughout the healing period for comfort
Full instructions will be provided in writing, and the team at The Vision Surgeon is available to answer any questions about your drop regimen between appointments.
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Major issues are fortunately rare, and we would prefer to be contacted with a ‘false alarm’ than a potential issue ignored.
All patients receive Dr Rylan Hayes’ contact details post-operatively. You should call him or seek urgent care if you experience:
Sudden significant worsening of pain (beyond the mild discomfort expected in the first 48 hours)
Sudden, marked decrease in vision
Increasing redness and discharge beyond the first 48 hours
Any visible tissue appearing to separate or detach from the surgical area
Fever associated with eye symptoms
Some redness, mild discomfort, and occasional blurring in the first week is entirely normal. If in doubt, contact the practice directly — the team will advise whether you need to be reviewed urgently.
COSTS & REFERRALS
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A referral from your GP or optometrist is required to access Medicare rebates for your specialist consultation. Without a valid referral, the full consultation and surgical fees apply and no Medicare benefit is payable.
Referrals from optometrists are accepted and are often the most direct pathway — many patients are identified and referred by their regular optometrist during routine eye examinations. GP referrals are equally welcome.
Although you can request your GP or optometrist refer you directly to Dr Hayes, he is also able to accept any referral even if not named specifically to him. This allows patients from local and abroad to seek out our signature no-stitch pterygium surgery, regardless of who they were referred to.
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Private health insurance HOSPITAL COVER (if adequate level is held) typically covers hospital and theatre fees for medicare rebatable procedures, as well as a portion of the surgical fee.
Pterygium surgery is a Medicare-rebatable procedure. The surgery attracts a Medicare benefit for both the surgical removal fee (MBS item 42656), the surgical autograft with glue fee (MBS item 42641) and the anaesthetic.
An out-of-pocket gap of $2000 will generally apply for the signature no-stitch pterygium surgery package. Additional hospital and anaesthetic fees are dependent on your level of private health insurance and excess. The exact fee structure — including out-of-pocket costs for the surgical consultation, the surgery itself, and the facility fees — will be provided to you in full, in writing, prior to scheduling surgery. There are no hidden costs.
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Private health insurance is not a requirement for surgery with Dr. Hayes, but it is beneficial. Without private health insurance, patients are responsible for the full facility and theatre fees.
The practice will provide a full fee estimate at consultation so you can understand your total out-of-pocket costs regardless of insurance status before making any decision about proceeding.
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Many patients travel from Brisbane, regional Queensland, and interstate to have their pterygium treated with the signature no-stitch pterygium surgery technique. Pterygium surgery is a procedure where outcomes differ meaningfully depending on the surgeon and technique — a higher recurrence risk is not something that becomes apparent until a year or two later, at which point the patient faces a second, more difficult surgery.
For patients travelling from a distance, the practice works to consolidate appointments where possible - potentially even provisionally booking a theatre slot the same week as the initial appointment. Dr. Hayes may also be able to collaborate with referring optometrists for portions of the post-operative follow-up care so that not all review appointments require travel to Maroochydore.
ABOUT DR HAYES
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Dr. Rylan Hayes holds an MBBS (medical degree) and FRANZCO — Fellow of the Royal Australian and New Zealand College of Ophthalmologists — the peak specialist qualification in Australian ophthalmology. He has subspecialty interest and training in anterior segment surgery, including pterygium, cataract, and corneal conditions.
He is also a certified laser refractive surgeon (LASIK, PRK, No-Touch Trans-PRK), a certified MINIject® glaucoma surgeon, and the founder and principal surgeon of The Vision Surgeon in Maroochydore, and developer of the signature no-stitch pterygium surgery technique.
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Yes. Dr. Hayes sees and manages recurrent pterygiums — cases where a previous surgery (performed elsewhere) has failed and the pterygium has grown back. These cases are surgically more demanding due to scar tissue and altered anatomy from the prior procedure, and they carry a higher inherent recurrence risk even with optimal technique. Dr. Hayes will counsel you fully on expectations and the approach for a revision case at consultation.
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Dr. Hayes is a specialist ophthalmologist who offers a range of services at The Vision Surgeon, including cataract surgery with premium intraocular lens options, laser vision correction (LASIK, PRK, No-Touch Trans-PRK), corneal surgery, MIGS glaucoma procedures including MINIject®, and intravitreal injections. Pterygium surgery is a particular area of focus and interest, but it sits within a broad and active surgical practice.
STILL HAVE QUESTIONS?
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Dr. Hayes - The Vision Surgeon
The best answers to your questions come from a direct assessment. A referral from your GP or optometrist gets the process started.