Pinguecula | Causes and Preventive Measures | Ophthalmology

Pinguecula

What is a pinguecula?

A pinguecula is a fairly common non-cancerous development that forms on the conjunctiva or white tissue near the cornea. It is a yellowish patch or bumps, and it usually forms on the inner side of the eye, near the nose. It is caused by changes in the tissue of your conjunctiva. These changes have been linked to irritation caused by exposure to the sun, dust, and wind, and are more common as we age. These lumps or growths can contain a combination of protein, fat, or calcium, or a combination of all three.

What causes pingueculae?

It forms when the tissue in the conjunctiva changes and creates a small bump. Some of these bumps cover fat, calcium, or both. The reason for this change is not fully understood but has been linked to frequent exposure to sunlight, dust, or wind. Pingueculae also incline to become more common as people age.

Signs and symptoms of pinguecula

In most people, pingueculae don’t cause many symptoms. But when they do, those symptoms are usually due to a tear film tear. Because it is an elevated bump on the eyeball, the natural tear film may not spread evenly across the surface of the eye around it, causing dryness.

This can cause dry eye symptoms such as burning, stinging, itching, blurred vision, and a foreign body sensation. Another symptom of pingueculae is the appearance of extra blood vessels in the conjunctiva that lines the sclera, causing red eyes.

In some cases, the pingueculae can develop swollen and inflamed. This is called pingueculitis. Irritation and redness of the eyes from pingueculitis is typically the result of excessive exposure to sunlight, wind, dust, or very dry conditions. Sometimes people mistake pingueculae for eye growths called pterygium, but they are different.

Treatment of pinguecula

Pingueculae usually do not require treatment. However, if the growth is causing bothersome symptoms, a person can try medicine or over-the-counter (OTC) medications. Surgery is generally reserved for pingueculae that cause severe eye irritation and those that cause cosmetic problems.

The following sections describe these treatment options in more detail.

Over the counter drugs

  • Over-the-counter eye drops can be helpful for symptoms like dryness, burning, and itching. Some drops are labelled “false tears” and work like natural tears to help lubricate the eyes.
  • Many artificial tears contain preservatives. These can cause eye irritation in some people. If a person develops eye irritation, they should consider using preservative-free drops that come in single-use vials.
  • There are also eye ointments available. These tend to stay in the eye longer than artificial tears. Because of this, they may be suitable for more severe cases of dryness and discomfort. People should inform their ophthalmologist about the eye drops they use.

Prescription drugs

  • If over-the-counter eye drops and ointments do not relieve pinguecula symptoms, a doctor may recommend trying prescription eye drops.
  • Eye drops that contain a steroid can help with swelling and inflammation. They can also help relieve the unpleasant feeling of having sand or grit in your eye.

Surgery

  • Surgery may be an option for people who do not find relief from symptoms with over-the-counter or prescription treatments. Other people may choose to have the pinguecula removed for cosmetic reasons.
  • During the procedure, a surgeon will eliminate this disease. They will then use a special glue to transfer a piece of healthy conjunctiva to the area from which the pinguecula was removed.
  • A 2019 study found that surgery combined with a healthy connective tissue graft can remove pingueculae and alleviate associated dry eye symptoms.

Diagnosis of pinguecula

Usually, our doctors can diagnose this disease only through an eye exam. We may use a slit lamp, which allows us to closely examine all areas of your eye. This tool gives us the ability to detect abnormalities and determine the severity of growth. The closer a pinguecula is to your cornea, the greater the chance that the growth will affect your vision.

Prevention of pinguecula

If you spend a lot of time out-of-doors due to work or hobbies, you are more likely to develop this disease. However, you can help prevent these growths by wearing sunglasses when you are outside. You should wear sunglasses that have a covering that blocks the sun’s ultraviolet A (UVA) and ultraviolet B (UVB) rays. Sunglasses also help protect your eyes from the wind and other outdoor elements, such as sand.

Keeping your eyes moisturized with artificial tears can also help prevent this disease. You should also wear protective glasses when working in a dry and dusty environment.

Complications of pinguecula

  • The disease alone rarely causes serious complications. It generally does not affect vision and is not related to other eye diseases or cancer.
  • However, some people are uncomfortable with the appearance of this disease. They may want to have a surgical removal for this reason.
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