Pinguecula Vs Pterygium: Understanding Similar Eye Growths

Pinguecula and pterygium are growths that occur on the thin protective membrane of the eye called the conjunctiva.

Both growths have similar causes, and may look identical to the untrained eye—but they have important differences. Understanding pinguecula vs pterygium, the qualities they share, and how they differ can help patients make more informed choices about their eye health.

Pinguecula is a yellowish, raised growth that forms on the conjunctiva. These growths are usually limited to the conjunctiva, and don’t spread to other parts of the eye. A pinguecula will typically form on the side of the eye closest to the nose, although they can occur on either side of the eye.

When trying to understand pinguecula vs pterygium, a pinguecula can be made up of deposits of protein, fat, or calcium. In most cases these growths will not affect a patient’s vision. However, they can cause disruptive and irritating side effects such as dryness, redness, and inflammation in the affected eye.

A pterygium (also called surfer’s eye) is a raised, wedge-shaped growth made of fleshy tissue. This type of growth can occur on either side of the eye, as opposed to a pinguecula which normally forms on the side of the eye closest to the nose.

A pterygium will form on the conjunctiva, but can extend to other parts of the eye. In certain cases they can extend as far as the cornea (outer layer of the eye), affecting a patient’s vision.

In the most serious cases, pterygia can lead to decreased or distorted vision. These more serious side effects will occur as the growth covers and changes the shape of the cornea.

Patients with a pinguecula can experience a range of symptoms. The most common will be a small, yellowish patch on the conjunctiva.

Some other symptoms include:

• Red eye

• Itchy or irritated eyes

• Swelling

• Dry eyes

• Foreign body sensation or the feeling like there is sand or grit in the eye
  

Not all patients will develop symptoms, and most symptoms are not dangerous or disruptive to a patient’s vision.

Both pinguecula and pterygium share similar causes. The two growths occur as a result of changes in the conjunctiva. The most common cause of these changes in the eye is ultra violet (UV) light exposure. Patients with prolonged exposure to the sun’s UV light are at a greater risk for developing both pinguecula and pterygium.

Other than UV light, eye irritants such as wind and dust can cause both types of growth. The longer, and more frequently, a patient is exposed to these irritants the more likely they are to develop pinguecula or pterygium.

Both pinguecula and pterygium have similar causes and means of prevention. As UV radiation is the most common cause of the two growths, patients’ best means of prevention is minimizing UV light exposure.

Protective eyewear is the most reliable way of limiting UV light exposure. Patients should look for glasses that provide 99 to 100% UV or UV400 protection and block both UV-A and UV-B rays. Using broad-brimmed hats and avoiding the sun at the most intense times of the day are also dependable ways to limit UV light exposure.

Wind and dust are also causes of pinguecula and pterygium. With protective eyewear, patients can limit their exposure to these irritants. They may also prevent both growths by lubricating eyes and limiting exposure to environments with wind, dust, and other particles.

The diagnosis of both growths will begin with a comprehensive eye exam. During the exam, the doctor will often use a slit lamp to diagnose the pterygium. This instrument is a type of microscope that shines a bright narrow light into a patient's eye, allowing the doctor to get a better view to make their diagnosis.

An eye doctor may also perform a visual acuity test to measure overall vision and see if the growth on a patient's eye has affected their ability to see. If the doctor notices the growth is beginning to spread, they may take pictures to monitor it over time and schedule additional tests.

In most cases pinguecula will not need to be treated. Patients may opt for treatment if the growth is uncomfortable or affecting their vision.

The most common type of treatment is lubricating drops that relieve irritation from pinguecula. To relieve redness and swelling, a doctor can also prescribe steroid eye drops.

These drops will typically be enough to provide relief for patients with pinguecula, making surgery rare.

For non-serious cases of pterygium doctors will usually recommend either lubricating or steroid eye drops. These drops can relieve symptoms such as redness, dryness, and swelling.

In rare cases a patient may need surgery. This will only be recommended if prescription eye drops and ointments aren’t alleviating pain or if the pterygium is blocking vision and causing difficulty seeing.

In our office we recommend one of two procedures:

Conjunctival Autograft: As pterygium growth tends to recur, conjunctival autograft surgery is the most recommended treatment for it. The surgery not only removes the pterygium, but also reduces its chances of coming back. Furthermore, this procedure offers the best appearance results once completed.

Amniotic Membrane Graft: Another surgical option an eye doctor may employ, where a piece of amniotic membrane is sutured to the eye once the pterygium is removed.

Following surgery, the doctor may transplant a thin piece of normal tissue onto the affected area to minimize the chance the pterygium will grow back.