What is it?

A wing-shaped, vascular, fleshy growth of the conjunctiva (thin and transparent mucosa that covers the white part of the eye) that invades the cornea. It is usually located on the side of the eye closest to the nose, although it can happen on the opposite side. Pinguecula is a yellowish, raised growth on the conjunctiva. It’s usually on the side of the eye near to the nose, but can happen on the other side too. A pinguecula is a deposit of protein, fat, or calcium.

Symptoms

Although in the initial stages it can be asymptomatic, when it develops it can cause ocular discomfort, such as a foreign body sensation (grit), eye redness, itching, stinging, and dry eye sensation. In addition, as it grows on the cornea it can modify its curvature, producing visual disturbances, or reach the visual axis, reducing significantly vision.
With regard to pinguecula, in most cases there are no symptoms. Although, in some cases, it can become acutely inflamed and produce a clinical picture called “pingueculitis”, consisting of a red eye and local discomfort.

Causes

Pterygium and pinguecula have a common composition (degeneration of the conjunctiva) and are associated with the same causative agents. The main risk factor is exposure to ultraviolet radiation. It is also more frequent in patients exposed to irritants such as dust, sawdust, and/or wind. Other factors involved are chronic dry eyes and aging.

Diagnosis

A complete ophthalmic examination, with greater emphasis on the ocular surface, is sufficient to diagnose a pterygium or pinguecula. In rare occasions, a biopsy of the lesion is necessary to establish a differential diagnosis with potentially malignant conjunctival lesions.

Can pterygium / pinguecula be prevented?

Since its main risk factor is sun exposure, wearing sun glasses with adequate protection protects from the appearance of both pathologies. On the other hand, the use of protective glasses will also protect from other agents related to pterygium / pinguecula, such as dust, sawdust, and / or wind.

Treatment

The pinguecula does not usually require a treatment, beyond the purely symptomatic, (artificial tears to lubricate the eye).

With regard to pterygium, it can initially be approached with a symptomatic treatment using eye lubricants (tears) or a topical anti-inflammatory treatment (eye drops). If, despite treatment with tears and anti-inflammatory drugs, the symptoms persist or, if due to its size it causes visual disturbances, the recommended treatment will be surgery (remove the lesion). Once the pterygium is removed, in some cases, the ophthalmologist can implant the patient’s healthy conjunctiva in the affected area, which can reduce the risk of recurrence (the pterygium grows back).

Although in general terms pterygium surgery is performed on an outpatient basis and under local anesthesia, the technique to be performed must be individualized and adapted to the needs of each particular patient and the characteristics of the lesion to be treated.

In some cases there may be a recurrence of the lesion.