Pinguecula & Pterygium
A pinguecula is a yellowish, slightly raised lesion that forms on the surface tissue of the white part of the eye close to the edge of the cornea. They are typically found in the open space between your eyelids, which also happens to be the area exposed to the sun.
While a pinguecula is more common in middle aged to older people, they can also be found in younger people and even children. They are typically found on people who spend significant amounts of time in the sun, and especially those without sun protection such as sunglasses or hats.
Signs and Symptoms of a Pinguecula
In most people, a pinguecula causes few symptoms. However, a pinguecula that is irritated might create a feeling that something is in the eye called a foreign body sensation. In some cases, a pinguecula can become swollen and inflamed, a condition called pingueculitis. Irritation and eye redness from a pingueculitis usually results from exposure to sun, wind, dust, or extremely dry conditions.
Treatment of a Pinguecula
The treatment for a pinguecula depends on the severity of the growth and its symptoms. Everyone with a pinguecula can benefit from sun protection for their eyes. Lubricating eye drops may be prescribed for those with mild pingueculitis to relieve dry eye irritation and foreign body sensation. To relieve significant inflammation and swelling, steroid eye drops or non-steroidal anti-inflammatory drugs may be needed.
Surgical removal of a pinguecula may be considered in severe cases where there is interference with vision, contact lens wear, or normal blinking. Frequently, a pinguecula can lead to the formation of a pterygium.
A pterygium is a wedge or wing-shaped growth of benign fibrous tissue on the surface tissue of the sclera that begins to grow onto the cornea. A pterygium contains blood vessels so they are considered a fibrovascular growth. In extreme cases, a pterygium may grow further onto the eye's cornea and interfere with vision.
A pterygium is usually quite visible to others. A person who has a pterygium may become concerned about their personal appearance. As with a pinguecula, prolonged exposure to ultraviolet light from the sun may play a role in the formation of a pterygium.
Signs and Symptoms of a Pterygium
Many people with a pterygium do not experience symptoms or require treatment. A pterygium may become red, swollen, and some may become large or thick. This may cause concern about appearance or create a feeling of having a foreign body in the eye. A large and advanced pterygium can actually cause a distortion of the surface of the cornea and induce astigmatism and blurred vision.
How a Pterygium is Treated
Treatment depends on the pterygium's size and the symptoms it causes. If a pterygium is small but becomes inflamed, your eye doctor may prescribe lubricants or possibly a mild steroid eye drop to reduce swelling and redness. In some cases, surgical removal of the pterygium is necessary.
A pterygium may be removed in a procedure room at the eye doctor's office or in an operating room setting. A number of surgical techniques are currently used to remove a pterygium, and it is up to your eye doctor to determine the best procedure for you.
After the procedure, which usually lasts no longer than 30 minutes, you may need to wear an eye patch for protection for a day or two. For an uncomplicated surgery, you should be able to return to work or normal activities the next day.
Unfortunately, a pterygium can often return after surgical removal. In fact, the recurrence rate can be as high as 40%. To prevent regrowth after the pterygium is surgically removed, your eye surgeon may suture or glue a piece of surface eye tissue onto the affected area. This method, called autologous conjunctival autografting, is safe and lowers the chance of a pterygium from growing back. After removal of the pterygium, steroid eye drops may be used for several weeks to decrease swelling and prevent regrowth.
It is important to note that a pterygium removal can also induce astigmatism, especially in patients who already have astigmatism.
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