surfer’s eye: a be­nign im­po­si­tion

New Zealand Surfing - - Backwash - By Josh Berry

About 12 years-ago surf­board shaper Andy Jordan faced an ob­scure dilemma. Widely known for his knack of clock­ing-up nu­mer­ous hours in the wa­ter, Jordan had be­gun to have is­sues with an itch and red­ness de­vel­op­ing in his eye af­ter surf­ing. Upon seek­ing med­i­cal ad­vice he learnt that the be­nign growth stem­ming from the nasal side of his eye was in fact ‘surfer’s eye’ or a ‘Ptery­gium’ as it is la­belled in med­i­cal realms. “It was a bit like you had sand in it, it’d just hurt,” Jordan says upon the re­al­i­sa­tion the is­sue was some­thing more than or­di­nary. “Mainly when your eyes were tired it’d start to hurt, es­pe­cially af­ter surf­ing a lot my eyes would be re­ally sore.” Wind­ing the clocks for­ward to 2013, Ben Ken­nings from Surf­ing New Zealand be­gan to ex­pe­ri­ence a sim­i­lar is­sue to that of Jordan. As a young child Ken­nings had a glass bot­tle ex­plode into his eye re­sult­ing in se­vere trauma and scar tis­sue de­vel­op­ing. What started out as a scar soon turned into a ptery­gium al­though not the kind of ab­scesses seen with surfer’s eye. “It was a ptery­gium on the out­side of my eye, not the usual one on the in­side of the eye that surfers usu­ally get,” Ken­nings ex­plains. “It was still grow­ing into my eye and was start­ing to get close to my pupil. I’d been in the salt, sand and sun and stuff – the scar tis­sue just grew over it to pro­tect it. When I went to go and get my eyes tested they said ‘look that’s slowly go­ing to grow over and one day you’re go­ing to have to get that op­er­ated on’ but that was the best part of 25 years ago they were talk­ing about that and I only had it done last year.” Ptery­gium (tuh-rij-ee-uhm), also known as ‘surfer’s eye’, is a be­nign growth formed through ex­ces­sive ex­po­sure to the suns harsh ul­travi­o­let rays. Gen­er­ally speak­ing it is an over­growth of the con­junc­tiva, the mem­brane/skin that cov­ers the white of the eye. When out in the sun­shine for par­tic­u­larly long pe­ri­ods an over­growth of the con­junc­tiva can be­gin to de­velop. Over a num­ber of years this over­growth can even­tu­ally grow across the eye and, if left un­treated, can re­sult in loss of vi­sion. There­fore the risk for surfers is very high. But what re­ally makes mat­ters worse is New Zealand’s ge­o­graph­i­cal lo­ca­tion and prox­im­ity to the ozone-layer hole, an at­tribute leading to hun­dreds of surfers fac­ing treat­ment for ptery­giums each year. New Zealand and Aus­tralia have some of the most in­tense ul­tra-vi­o­let rays on the planet be­cause of their prox­im­ity to the ozone-layer hole. This re­sults in higher cases of skin can­cers than most coun­tries, es­pe­cially in older gen­er­a­tions. Whilst a ptery­gium ob­vi­ously isn’t a cancer, the need for med­i­cal con­sul­ta­tion is preva­lent. Dr Sue Or­monde from Auck­land Eye says New Zealan­ders’ aware­ness of ptery­gium is grow­ing. “I came orig­i­nally from the UK and have only been in New Zealand for 13 years. In the UK we would see very few of them (ptery­gium) and we may have only op­er­ated on two-three a year whereas here in New Zealand we lit­er­ally do hun­dreds a year.” Sur­gi­cal treat­ment for people with ptery­giums has be­come more at­tain­able in New Zealand as a re­sult of the num­ber of cases grow­ing. The treat­ment it­self in­volves a brisk 10-15 minute pro­ce­dure in which the ptery­gium is lit­er­ally peeled away whilst the pa­tient is un­der anaes­the­sia. The anaes­thet­ics can be given in the form of eye drops, an in­jec­tion or

both meth­ods com­bined. Dur­ing surgery, if the ptery­gium is peeled off and noth­ing else is done it will grow back quite rapidly. To counter-act re-growth, a piece of the healthy con­junc­tiva is taken from the top of the eye­ball un­der­neath the eyelid. From here it is then glued into the po­si­tion where the ptery­gium was taken away from. Or­monde says ad­vances in the pro­ce­dure have al­lowed for a less time con­sum­ing oper­a­tion also al­low­ing for the pa­tient to be more re­laxed. “Go­ing back a few years ago when we used to stitch the con­junc­tiva in place, people were quite un­com­fort­able with that be­cause they could feel the stitches scratch­ing on the sur­face. Now we’ve got these spe­cial glues that set in a cou­ple of min­utes and they’re much more com­fort­able af­ter­wards.” While this may sound straight-for­ward enough, the fol­low-on ef­fects of the oper­a­tion are what Jordan de­scribes as “prob­a­bly the worst thing I’ve ever gone through, it’s pretty gnarly! I’ve had the ear (surfer’s ear) oper­a­tion done and the ptery­gium was way worse, I don’t want to go through it again.” The ini­tial re­cov­ery pe­riod af­ter treat­ment can be dev­as­tat­ing depend­ing on the sever­ity and size of the ptery­gium that was re­moved. The pro­ce­dure has come a long way in re­cent times but the two ag­o­nis­ing weeks af­ter surgery are, in Jordan and Ken­nings opin­ions, a large hur­dle to re­cov­ery. Ken­nings bluntly re­calls the aftermath of his surgery as ag­o­nis­ing. “You just go in, get the drops, they just sort of cover your face, squeeze shit in your eye and start cut­ting away at it. My mates who’d had it said you need to take some Panadol in with you and down them as soon as you’re fin­ished which I did - but the doc­tor said you’ve got to get to the med­i­cal cen­tre straight away and get more pain re­lief. By the time I got to the med­i­cal cen­tre and got that, I was pretty much hor­i­zon­tal in the car and in the most pain I’d ever been in.” Af­ter all of this, Ken­nings grov­elled his way back home to Whanga­mata where he rested for two weeks. In a month or two most of the bleed­ing had gone and his eye has been good ever since. In hind­sight, Ken­nings and Jordan sac­ri­ficed only a short pe­riod of suf­fer­ing in the grand scheme of things. Ken­nings was back in the wa­ter af­ter two months and Jordan was back surf­ing af­ter a month. Both surfers have taken to wear­ing sun­glasses a lot more as their main pre­cau­tion­ary mea­sure. Due to Ken­nings’ child­hood scar he had to take steroid drops for three months to help with re­ha­bil­i­ta­tion. Since his surgery he has con­tin­ued to surf just as much as he used to yet he is aware that a re-growth could spark up with lit­tle no­tice. The re-growth of a ptery­gium is some­what of an is­sue but med­i­cal ad­vances have nar­rowed these re­cur­rences down to a small per­cent­age. Dr Or­monde says “by glu­ing the piece of healthy con­junc­tiva, the re­cur­rence rate is very low – prob­a­bly less than five per­cent - it’s not im­pos­si­ble, but if they do grow back you can sim­ply re­peat the pro­ce­dure.” How­ever the cost of re­moval has es­ca­lated sub­stan­tially in the last decade. The price of the pro­ce­dure varies and is greatly de­pen­dent on whether the pa­tient is hav­ing one or two ptery­gia re­moved. To get one ptery­gium re­moved

“It was still grow­ing into my eye and was start­ing to get close to my pupil. I’d been in the salt, sand and sun and stuff – the scar tis­sue just grew over it to pro­tect it.”

can cost be­tween $2700-$4100 (NZD) whereas to get two ptery­gia re­moved it can be any­where up to $4500$6100 (NZD). The other vari­ables which con­sti­tute price de­pend on which anaes­thetic a pa­tient chooses and whether a glue or stitch method is used. The af­ford­abil­ity of treat­ment has de­creased in com­par­i­son to 12 years ago when Jordan had his re­moved. He re­calls his ptery­gium surgery hav­ing no mon­e­tary value. “I did a deal with the doc­tor and made him a surf­board so it didn’t ac­tu­ally cost me any­thing but I think at the time it was about a grand or 900 bucks or some­thing.” Be­cause Ken­nings’ ptrey­gium was a ‘trauma ptery­gium’ he was told there was a 50 per­cent chance it could grow back in the six months fol­low­ing his surgery. Upon see­ing a specialist in the fol­low­ing weeks this was made clear to him, but the doc­tor said his looked fine and he was given the all clear. “It hasn’t grown back yet, touch­wood, which is pretty cool but if it did I don’t know if I’d go through it again,” Ken­nings says. “It may grow back, and well I guess so be it.” In ret­ro­spect, Jordan has had no is­sues ei­ther since his surgery 12 years ago. In this time he has con­tin­ued to surf in be­tween stints in the shap­ing bay. But liv­ing and surf­ing in The Mount has meant he has to be weary of the East Coast’s harsh morn­ing ul­tra-vi­o­let rays. Be­cause of this, his days of surf­ing in the dawn have be­come less reg­u­lar. “Un­less there’s a re­ally good bank or I’m go­ing to The Is­land early, I’ll try to go out a bit later.

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