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Pingueculae & Pterygia

Pingueculae and Pterygia are different types of benign lesions or growths that occur on parts of your eye. Here is a basic explanation of what they are, their respective symptoms and treatments.

Pingueculae

Pingueculae (called pinguecula in singular tense) are slight protrusions on the surface of your sclera, which is the white part of your eye. They are yellowish in color and form close to the edge of your cornea. Typically, these lesions form in the open area between your eyelids, which corresponds to the area most exposed to the sun.

More common in middle-aged or older people who spend extended periods of time in the sun, pingueculae can also appear in children and younger people. Likely they are a result of being outdoors in bright sunlight without wearing adequate protection, such as hats or sunglasses.

Signs and Symptoms

Pingueculae do not generally have symptoms, yet when irritated they may cause a sensation that something foreign is stuck in your eye. When they become inflamed and swollen, pingueculitis is diagnosed. This typically results from exposure to environmental elements, such as wind, dust, dry air or sunlight.

Treatment

Treatment varies depending upon the symptoms and severity of pingueculae. Sun protection, such as sunglasses with 100% UV protection, is always recommended. Lubricating eye drops may also be prescribed to alleviate symptoms. When swelling is significant, steroid eye drops or non-steroidal anti-inflammatory drugs may be indicated.

Extreme cases that cause vision problems, such as an inability to wear contact lenses or blink normally, may require surgical removal of the pinguecula.

Pterygia

Pterygia (pterygium in the singular tense) are wedge-shaped growths that occur on the surface of the sclera. They are composed of benign fibrous tissue and contain blood vessels, making them a fibrovascular growth. Exposure to harmful sun rays of UV light probably influence the formation of pterygia. Sometimes they occur as an outgrowth of pingueculae.

Pterygia are generally visible to others, which causes concern about physical appearance for many people.

Signs and Symptoms

Very often there are no symptoms and no treatment required for ptergygia. Sometimes the lesions become red and swollen, or enlarged and thick. The sensation of a foreign body in your eye may result.

Very large pterygia can effect a distortion of the corneal surface, which may cause blurred vision and create astigmatism. In rare, extreme cases, pterygia actually grow onto the cornea and interfere with vision.

Treatment

If a pterygium is small yet becomes swollen, your eye doctor may treat it with prescription lubricants or a mild steroid eye drop. Surgical removal is also necessary for some severe cases and when the patient is very disturbed by the physical appearance.

Surgery is performed at the doctor’s office or in an outpatient operation room. A variety of procedures could be used, and it is up to your doctor’s judgment to determine the most appropriate surgery for your case. The entire surgery takes about a half an hour, and you may be required to wear an eye patch for a day or two afterwards. Normal activities can generally be resumed on the next day.

Unfortunately though, pterygia have a very high rate of recurrence – up to 40%. To safely prevent regrowth, your eye surgeon may attach a piece of surface eye tissue onto the affected area. Called conjunctival auto grafting, this piece is either glued or sutured in place and decreases the chance of pterygia growing back. After surgery, steroid eye drops are usually applied for a few weeks in order to reduce swelling. One possible and common side effect of pterygium removal is the development of astigmatism.