Dr. Orwa Nasser MD MPH - Pinguecula

Pinguecula

Pinguecula is a common, benign growth on the conjunctiva, the clear membrane covering the white part of the eye. It appears as a yellowish, slightly raised bump near the edge of the cornea. Pingueculae are typically harmless and do not spread to other parts of the eye. The condition usually develops slowly and may appear in one or both eyes. Although often asymptomatic, it can sometimes cause irritation or cosmetic concern.

Symptoms:

·    Yellowish raised bump on the white of the eye.

·    Redness or mild irritation.

·    Dry or gritty sensation.

·    Burning or itching.

·    Watery eyes.

·    Discomfort with contact lens wear.

Causes: Pinguecula is strongly associated with long-term environmental exposure and ocular surface irritation.

·    Ultraviolet (UV) light exposure: Chronic exposure to sunlight is a major contributing factor in the development of pinguecula.

·    Environmental irritants: Wind, dust, smoke, and dry climates can irritate the conjunctiva and contribute to tissue changes.

·    Age and repeated exposure: Pingueculae are more common in adults who have spent many years outdoors without consistent eye protection.

·    Contact lens wear: Contact lenses may worsen irritation in individuals with pinguecula.

Diagnosis and Tests: Diagnosis is made during a comprehensive eye examination. A slit-lamp examination allows detailed assessment of the growth’s size, shape, and location. Pinguecula is clinically distinguishable from pterygium, which extends onto the cornea.

Management and Treatment:

·    Observation and supportive care: If asymptomatic, no treatment is required. Regular monitoring may be recommended.

·    Symptom relief: Lubricating artificial tears and avoidance of environmental irritants help relieve discomfort.

·    Anti-inflammatory treatment: Short-term anti-inflammatory eye drops may be prescribed if inflammation (pingueculitis) develops.

·    Surgical intervention: Surgery is rarely required and is generally reserved for significant discomfort, cosmetic concerns, or interference with contact lens wear.

Prognosis:

·    The prognosis for conjunctival cysts is excellent.

·    Most remain stable or resolve without complications.

·    Removal procedures generally result in full recovery.

·    Recurrence may occur, especially if underlying irritation persists.

Prevention: Protective measures help reduce risk and progression:

·    Wear UV-protective sunglasses outdoors.

·    Use wide-brimmed hats in bright sunlight.

·    Protecting eyes from wind and dust.

·    Use lubricating drops in dry environments.

When Should I See My Healthcare Provider? Seek evaluation if irritation persists, redness worsens, or vision becomes blurry.

When Should I Go to the Emergency Room? Emergency care is necessary for sudden vision loss, severe eye pain, or signs of infection.

What Questions Should I Ask My Healthcare Provider?:

·    Is this definitely a pinguecula?

·    How can I reduce irritation?

·    Could this develop into pterygium?

·    Do I need protective eyewear?

Key Takeaways:

·    Pinguecula is a benign conjunctival growth.

·    UV exposure and environmental irritation are key risk factors.

·    Most cases require no treatment.

·    Lubrication and protection reduce symptoms.

·    Surgery is rarely needed.