Pinguecula and Pterygium

A pinguecula is a yellowish non-cancerous growth on the surface of the cornea. Generally, they will form in the corner of the eye near the nose, although they may occur elsewhere. 

 A pterygium is an eye growth that occurs on the cornea of the eye. The growth is a pinkish, triangular shaped tissue growth. It generally grows slowly, starting from the corner of the eye and moving towards the cornea. In advanced stages, it could interfere with the patient’s vision by inducing astigmatism or obscuring the pupil area.

Causes of Pinguecula and Pterygium
The causes of both pinguecula and pterygium are excessive exposure to UV rays alongside dry eyes and exposure to surrounding environmental factors which can irritate the eyes. Such irritants include dust, smoke, wind, dry weather, etc. These conditions are more common in hotter climates, especially for people who work outdoors or like to spend time outdoors in such hot climates.
To diagnose either condition, the doctor will perform a standard eye examination alongside a review of the patient’s medical history. Generally, pinguecula and pterygium are able to be diagnosed through a simple visual observation.  
The following can help in preventing pinguecula and pterygium:

  • Wearing a brimmed hat and UV protection sunglasses whenever out in bright sunlight; sunglasses will also provide protection from dust and debris, even when there is no bright sunlight.  
  • Staying away from areas with heavy dust, smoke, smog, dry weather, or heavy wind.
  • Rest your eyes efficiently if they are constantly strained; focusing on a far distance once every half an hour may help relax them. Artificial tears may be used when eyes feel dry.
If a patient has already been diagnosed with pinguecula or pterygium, they must consistently monitor their eyes for any additional changes and abnormalities — paying attention to both color and size. If any changes are observed, the doctor should be consulted as soon as possible.   
 
For both pinguecula and pterygium, if the condition is not too severe, patients may only notice a growth on the eye. In instances where inflammation occurs, the patients will generally experience pain, irritation (a feeling that “something is in the eye”), redness, burning, and excessive tears. In severe cases, the mass can reach inside the cornea and affect vision. This can also lead to astigmatism, resulting from the growth pulling on the eye.
Treatment of pinguecula or pterygium depends on their severity. It is not considered severe if the patient only has a small growth which doesn’t affect vision. Treatment for non-severe cases involves preventing further progression by protecting the eyes against harmful UV rays (e.g., wearing protective sunglasses). For the more severe cases, in which prolonged and severe inflammation occurs, the doctor may prescribe medicated eye drops.

If the growth expands to where it reaches the cornea and affects vision, either by the mass obscuring the pupil area or by astigmatism developing as a result, the doctor may recommend surgery to remove the growth. Surgery takes roughly 30 minutes to complete. After the surgery, patients should rest for 3-6 hours and can return home the same day.  

Unfortunately, the chance of recurrence is high for pinguecula or pterygium, especially in younger patients or patients who overexpose themselves to UV light.

However, if surgery is involved, to lower the chances of recurrence post-surgery, doctors are able to utilize new transplantation methods. The methods involved include removing the growth and covering the bare scleral area, using the patient’s own conjunctiva or using amniotic membranes (available from the Thai Red Cross). In severe, multiple recurrent pinguecula or pterygium, mitomycin C eye drops have been reported to prevent recurrence, but it is not part of the standard protocol.  

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