Pterygium and Pinguecula

Eye Anatomy

Pterygium and pinguecula are growths on the cornea (the clear front window of the eye) and the conjunctiva — the thin, filmy membrane that covers the white part of your eye (sclera). Both growths are noncancerous and are fairly common.

Pterygium and Pinguecula

Pterygium

Condition

A pterygium is a triangular-shaped growth of fleshy tissue on the white of the eye that eventually extends over the cornea. This growth may remain small or grow large enough to interfere with vision. A pterygium can often develop from a pinguecula.

Pinguecula

A pinguecula is a yellowish patch or bump on the conjunctiva, near the cornea. It most often appears on the side of the eye closest to the nose. It is a change in the normal tissue that results in a deposit of protein, fat, and/or calcium. It is similar to a callus on the skin.

It is not entirely clear what causes pterygia and pingueculae to develop. Ultraviolet (UV) light from the sun is believed to be a factor in the development of these growths. Other factors believed to cause pterygia and pingueculae are dry eye and environmental elements such as wind and dust.

Symptoms

In most people, the first sign of a pinguecula is a yellowish patch or bump on the conjunctiva, usually on the side of the eye closest to the nose.

A pinguecula usually has few symptoms, however, if it becomes irritated, you may feel as if you have something in your eye. In some cases, pingueculae become swollen and inflamed. Irritation and eye redness may occur, particularly if there is significant exposure to sun, or a windy, dusty, or a very dry environment.

With a pterygium, some people may have no symptoms other than the growth appearing. For others, especially those who have a pterygium that is growing, there can be redness, inflammation, or both.

Symptoms of both pterygium and pinguecula can range from mild to severe and may include:

  • Redness and/or inflammation-especially during the growth of a pterygium
  • Blurred vision
  • Itching
  • Burning
  • Gritty feeling
  • Feeling of having foreign material in the eye

Treatment

Pterygia and pingueculae generally don't require treatment until symptoms are severe enough. When pingueculae or pterygium become red and irritated, lubricating eyedrops or ointments or possibly a mild steroid eye drop may be used to help reduce inflammation.

If these growths become large enough to threaten sight or cause persistent discomfort, they can be removed surgically through an outpatient procedure. They are also sometimes removed for cosmetic reasons.

For milder pterygia, a topical anesthetic can be used before surgery to numb the eye's surface. The eyelids will be kept open while the pterygium is surgically removed. An eye patch may need to be worn for protection for a day or two. Patients can typically return to work or normal activities the next day. Note that pterygium removal can cause astigmatism, especially in people who already have this refractive error.

After removal of the pterygium, steroid eye drops may be used for several weeks to decrease swelling and prevent regrowth.

Despite proper surgical removal, a pterygium may return. In fact, the recurrence rate is between 30 and 40 percent, and is more likely among people under age 40. To prevent regrowth after surgery, the doctor may suture or glue a piece of surface eye tissue onto the affected area. This method, called autologous conjunctival autografting, has a low recurrence rate. Medications that prevent tissue growth are sometimes used to help prevent recurrences of pinguecula or pterygium.

The best way to avoid recurrence of pinguecula or pterygium after treatment is to limit exposure to the environmental factors that contribute to their growth. Adequate UV protection should be used with sunglasses and eye protection in dry, dusty conditions. Artificial tears are beneficial when in dry conditions.