While pingueculae and pterygia are among the most common ophthalmic disorders that ophthalmologists encounter, fewnon-physicians have ever heard of these conditions. Pingueculae and pterygia are classified as "degenerations" of the conjunctiva; the conjunctiva is the clear membrane which covers the sclera (the white) of the eye. More specifically, pingueculae and pterygia are proliferations of conjunctival tissue; they are usually adjacent to the cornea, most commonly found at the three and nine o’clock positions. At times, these conditions may even extend over the cornea as a triangular sheet of tissue. The color is usually white, but may be gray or yellow in certain individuals. They are more commonly seen in people from sunny or windy climates. In addition, people who are exposed to UV radiation (arc welders who do not wear sufficient eye protection) are more prone to developing pingueculae and pterygia. Because of this, it is recommended that those who are exposed to these environments wear eye protection (such as UV-protected sunglasses) whenever necessary1.
When the proliferation of conjunctival tissue is localized over the sclera it is called a pinguecula. While most people who have this condition are not symptomatic from it, some complain of chronic irritation and tearing. The majority of these people can be treated symptomatically with eye lubricants, such as artificial tears. A small percentage of people with pingueculae may benefit from surgical removal. The most common reason for surgical removal is persistent irritation despite adequate treatment with drops. Another, though less common, reason for removal is to allow for greater ease in contact lens wear.
If the conjunctival proliferation covers part of the cornea, it is called a pterygium. While pterygia generally cause more symptoms than pingueculae, many people can tolerate them without treatment. In addition to causing irritation, pterygia can cause tension on the cornea and create astigmatism requiring correction with astigmatic glasses or contact lenses. Indications for surgical excision of pterygia include those listed for pingueculae. In addition, advanced pterygia may grow to such an extent that they may block the axis of vision. When this happens, surgical excision is usually required.
Surgical removal of pterygia or pingueculae can typically be performed under local anesthesia with the patient returning home the same day. In the majority of cases, only local or eye drop anesthesia is required. Pingueculae can usually be removed with simple excision, and usually do not recur after surgery2. On the other hand, pterygia recurrences after excision are common. Lately, more sophisticated techniques have reduced the number of recurrences significantly3,4. For example, in one of the more popular techniques employed today, the pterygium is excised, and then, a small, healthy piece of conjunctiva from another part of the same eye is then moved into the affected area3.
While ophthalmologists can easily discern most pterygia and pingueculae from other lesions in the eye, there are many conditions that may look similar. Among these include certain cancers and infections. Therefore, it is recommended that people who believe they may have this condition visit their ophthalmologists without much delay.
Some of the concerning signs include:
People who have one or more of the above are recommended to see their ophthalmologist without delay so that possible sight threatening or more serious eye diseases may be detected early enough to be safely treated.
References:
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