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PhilHealth upgrades pterygium treatment standards

PTERYGIUM, most commonly known as ‘pugita sa mata,’ is a triangular, fleshy, fibrovascular sheet originating from the conjunctiva and extending to the corneal limbus and beyond.
PTERYGIUM, most commonly known as ‘pugita sa mata,’ is a triangular, fleshy, fibrovascular sheet originating from the conjunctiva and extending to the corneal limbus and beyond. PHOTOGRAPH COURTESY OF WIKIPEDIA
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PhilHealth’s new policy that sets clear quality standards and clinical guidelines for the treatment of pterygium takes effect on 15 November 2025.

Developed in consultation with experts from the Philippine Academy of Ophthalmology and the Philippine Cornea Society Inc., the policy focuses on quality of care and patient safety and ensures that surgical procedures received by members meet the latest, high standards of care applicable in the local settings.

PhilHealth Circular No. 2025-0021 implements a maximum claim limit for eye surgeons to help ensure patient safety and proper utilization of benefits.

PhilHealth currently covers pterygium excision with graft ocular surface reconstruction.

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