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Pinguecula

The conjunctiva is the connective tissue that covers the whites of your eyes. While it is very important, it is also prone to degeneration.

A pinguecula is a type of growth that occurs due to conjunctival degeneration. It is a small yellow or white deposit on either side of the pupil, but most commonly appears on the nasal side of the eye. Surrounding the clump is normally a yellowish film. The deposits themselves are due to a thickening and deterioration of the conjunctiva. This causes proteins, fats, or calcium to build up there. They may or may not occur bilaterally.

Although a definite cause is unknown, they are most likely caused by ultraviolet rays from the sun. Because of this, the condition is common amongst people who have been exposed to the sun for a long time or those living in the tropics. The reason pingueculae occur on the nasal side is because the nose is highly reflective and can direct UV rays towards the conjunctiva. Additionally, the whiteness of the sclera can reflect light back towards the conjunctiva. Windburn and exposure to dirt and sand have also been shown to cause the growths to occur.

Luckily, most pingueculae do not cause any negative symptoms besides for cosmetic ones. A pinguecula is benign, but may continue to grow. It may become slightly raised off of the cornea and cause a feeling of something in your eye. It also may be more difficult to wear contacts due to the irregular shape of the eye. It can also cause the mucous and tear film over the eye to change its composition, making it harder to take contacts on or off. Pingueculitis is a condition when the pinguecula becomes more advanced. It’s characterized by an inflamed pinguecula that causes the eyes to become inflamed, red, and itchy. Untreated growing pinguecula can lead to the development of pterygia.

Eye drops can be used to reduce redness and discomfort, while anti-inflammatories and steroids are used to treat pingueculitis. Surgery is only performed in rare cases due to complications that can arise after. Smaller pinguecula can be removed through laser surgery, which has a lower chance of causing hemorrhaging or corneal scarring. Larger growths must be removed by hand and have a higher risk for negative side effects. Laser surgeries also have a lower rate of recurrence of pingueculae. Again, surgery is only recommended to those with severe pingueculitis that can turn into pterygia or those who have trouble blinking or putting on contacts. However, many chose to go through with surgery for cosmetic reasons, as pingueculae can be very unsightly.