A pinguecula is a benign growth of slightly raised conjunctival tissue, the clear part of tissue covering the white part of your eye (sclera) and the inside of your eyelids. It is most commonly located nasal to the cornea but can also be temporal. It sits on top of the sclera and stays confined within the conjunctiva meaning that it never grows over the cornea. It is usually more common in people with significant sun exposure. Other less important risk factors include exposure to dust and wind. Dry Eye is also a risk factor as it can increase the growth of a pinguecula.
Figure 1: Pinguecula
A pinguecula is usually asymptomatic although it can sometimes cause ocular redness, foreign body sensation and/or itching form inflammation and/or swelling. In this case, treatment with lubricating and/or steroid drops can be given. In rare cases where the pinguecula becomes very uncomfortable or is creating contact lens intolerance or cosmetic problems, it can be surgically removed.
A pterygium is a benign growth of the conjunctiva that extends over the surface of the cornea. It may start as a pinguecula. It is also most commonly located nasal to the cornea although it can be temporal. Its causes are the same as that of a pinguecula. It can pull on the cornea as it grows over it, causing corneal distortion. This can result in blurred vision due to astigmatism and higher order aberrations. Therefore, it is important to have a pterygium removed as soon as possible to avoid permanent corneal distortion.
Figure 2: Pterygium
When a pterygium is small and only causing discomfort, redness and/or swelling, treatment may only consist of lubricating and/or steroid drops. When medical treatment does not relieve symptoms or the pterygium is large enough to cause corneal deformation with secondary astigmatism or higher order aberrations, surgical removal is recommended. A conjunctival autograft , which consists of harvesting healthy conjunctival tissue from the superior part of the conjunctiva under the upper eyelid, is transplanted on the affected area where the pterygium has been removed. This will minimize the chance of the pterygium growing back. It will also give a better postoperative cosmetic appearance.
The best way to prevent recurrence of a pterygium or pinguecula is to avoid dryness and sunlight and to always wear sunglasses when outdoors for ultraviolet protection.
If you have a pingueculm or a pterygium and would like to know more about its treatment, contact us today to schedule an appointment with Dr George Khouri.