When model Thom Evans noticed small, ugly growths in the corners of both eyes, close to his nose, he was worried that they might eventually affect his vision.
"I was also worried that they might appear in close-up shots in my modeling and acting," says Thom, 34, a former Scottish international rugby player, who broke his neck in 2010 in a game between Scotland and Wales Six Nations.
"They were especially noticeable when I was tired and empty – I suspect they were red and sore because people would ask me what they were," says Thom, who is single and lives in London. "I had a growth of 2 mm in each eye."
Thom first noticed the nodules when he was 17 and told an optician who told him they were called pterygium, also known as & # 39; surfer & # 39; s eye & # 39; s.
Face for sore eyes: handsome model and actor Thom Evans suffers from a condition called pterygium, which is due to not wearing sunglasses in childhood
These wing-shaped triangular pink wedges of fleshy scar tissue grow over the surface of the whites of the eye in response to damage caused by ultraviolet (UV) rays. In an estimated one in three cases, they can grow over the front of the cornea, the clear window at the front of the eye. They usually grow slowly for many years and affect both eyes, but their growth rate can be difficult to predict.
Harminder Dua, a professor of ophthalmology at the University of Nottingham and medical adviser to the charity Fight For Sight, says that a pterygium starts as a benign cosmetic blemish on the whites of the eyes, but as they grow and move on, they can get the cornea (called astigmatism) or cover the central cornea, causing blurred vision, double vision, and leading to severe vision loss.
If they affect vision, they can be removed by surgery.
"They can sometimes cause dehydration because the tear film cannot spread and break off over the irregular surface, exposing the surface and drying it out," says Professor Dua. This can cause irritation and inflammation, leading to redness.
"In the most extreme cases, when a pterygium grows over the central part of the cornea, it hinders the passage of light into the eye and can lead to severe vision loss," he adds.
However, the exact cause of pterygia is unknown. It is more common in countries near the equator where the exposure to UV rays in sunlight is high.
Chronic irritation from sand, dust and wind in a dry climate can also contribute. Surfers are mainly at risk because of the long time they spend in the sea, with exposure to both direct and reflected UV rays.
UV exposure: Thom grew up in the sunny Algarve of Portugal and spent most of his free time swimming, windsurfing and surfing
Nip / tuck: Surgical options, under local or general anesthesia, include excision (called a bare sclera resection), where the head and body of growth are removed with microsurgery – but this has reported a high recurrence rate between 24 and 89 per cent
& # 39; In the UK, pterygium growth is relatively uncommon due to the lack of strong sunlight, affecting 1 percent of the population, or about 670,000 people, & quot; said Ali Mearza, an ophthalmologist surgeon at Imperial College Healthcare NHS Trust , and Ophthalmologists in London, a private clinic. "In countries such as Australia, India and Africa, the prevalence can be 30 percent."
Thom grew up in the sunny Algarve of Portugal and spent most of his free time swimming, windsurfing and surfing. "Although I was careful to protect my skin, I did not wear sunglasses," he says.
"Skiing was another sport I loved, and although I sometimes wore glasses, I wasn't good at wearing them. I did not appreciate the risk of UV light reflected from the snow. & # 39;
In his late teens, the pterygium growths would make his eyes irritated and painful.
"It felt like I had grit or sand in my eyes and sometimes I needed eye drops for dryness," says Thom. "But most of the time they didn't really bother me.
"Over the years, opticians had told me they could be removed if they affected my eyesight, but I was also told that they usually grow back."
Mr. Mearza says that the more sun exposure you get, the greater the chance that pterygium growths will become irritating. "Wearing a wide-brimmed hat or cap and tight-fitting, CE-marked, tight-fitting sunglasses can reduce the risk of pterygium causing irritation," he says.
"It can be a challenge to let children wear sunglasses, but it's good to get them used to it early."
Mr. Mearza says that dryness caused by a pterygium can be managed with lubricating eye drops and redness treated with anti-inflammatory drops.
Pecs Call: Amazingly, feminists did not complain about the sexual objectification of Thom Evans during the fashion show & # 39; From Scotland With Love & # 39; in New York, 2012
"Optometrists should also regularly measure pterygium to check for any progression," he says.
& # 39; If the pterygium becomes larger than 2 mm to 3 mm and goes to the pupil, this can have a dramatic effect on vision and must be removed with surgery. Some people may notice changes in their vision at this stage, but others may not. & # 39;
This was Thom & # 39; s great fear five years ago when he was worried about the fact that the pterygia grew bigger in both eyes.
"I decided to have them removed because I was afraid that they could affect my eyesight," he says.
Surgical options, under local or general anesthesia, include excision (called a bare sclera resection), where the head and body of growth are removed with microsurgery – but this has a high recurrence rate reported between 24 and 89 percent.
Another option is a conjunctival autograft, where the pterygium is removed by surgery and then the area below is patched with a tissue transplant from the conjunctiva, the tissue that covers the eyelid and leaves no scar. This has a much lower recurrence rate, between 5 and 8 percent.
This was the solution that Thom chose in 2014.
& # 39; Surgery and a conjunctival autograft are currently considered the gold standard & # 39 ;, says Mr. Mearza, who treated Thom.
Professor Dua and his team in Nottingham have published research showing that injections of a drug called 5-fluorouracil (or 5-FU) into the abdomen of the recurring pterygium while still in the whites of the eye can occur that it goes to the cornea in almost all cases.
"Usually four injections are needed at weekly intervals, but some patients need 12 or more, says Professor Dua.
Thom, who retired after his accident in 2010, had one pterygium removed in 2014 through surgery and an autograft conjunctiva under general anesthesia.
The procedure took 30 minutes and he went home a few hours later. The growth in his other eye was removed three years ago, in the same way. He has not returned since then.
"It was a bit uncomfortable for two or three days, but fine after that," he recalls.
Thom now wants to convey the message about the importance of people protecting their eyes with sunglasses.
"Had I known then that not wearing sunglasses on the beach would cause my eyes to grow when I was growing up, I would certainly have worn them," he says. "I'm always careful now."
OTHER RISKS FOR YOUR EYES IN A HOLIDAY SEASON
Most of us know the dangers of the sun to our skin and we will work with sunscreen. But there is a good chance that we will miss an important area: the skin around our eyes.
Eyelids and the surrounding area are a hotspot for cancer because the skin is thinner and often unprotected.
Annually, approximately 13,600 cases of eyelid cancers are diagnosed, which is approximately 10 percent of non-malignant skin cancers diagnosed in the UK.
The most common types are basal cells and squamous cell carcinomas, which can start as small pimples or fleshy bumps, but can grow, bleed and form scabs.
Other changes that you should pay attention to are redness and inflammation of the eyelids, inexplicable loss of eyelashes and the lashes that turn white caused by pigment cells affected by the cancer. You should consult your doctor if you notice any of these changes.
The ultraviolet (UV) rays of the sun can also damage the eyes, causing sunburn on the eye surface and contributing to cataracts in the long term.
For example, UV damage can lead to photokeratitis, a kind of sunscreen of the cornea, the bright part at the front of the eye. This can be treated with mild steroid drops.
Cataract, a condition in which the lens becomes cloudy in the eye and the vision becomes blurred, is also thought to be accelerated by UV damage. Sunlight is thought to encourage proteins in the lens to clump together, making it cloudy.
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