Pterygium and Pingueculum

Pterygium and Pingueculum

Pterygium and pingueculae are degenerative growths on the surface of the eye. They are a fairly common condition and may occur in one or both eyes.

Pterygia are a benign growths of pink, fleshy tissue on the conjunctiva. They mostly start on the white of the eye, usually on the inner corner, and can continue to grow across the eye and eventually seriously affect sight. They should be checked by an eye specialist as, although benign, they contain blood vessels and can form scar tissue that may permanently disfigure the eye.

Pingueculae are often confused with pterygia. A pingueculae is a soft yellowish thickening of the conjunctiva adjacent to the cornea. It is similar to a pterygium, but does not grow onto the cornea. Although it can be removed easily, this is rarely necessary.

 

Causes

Pterygia and pingueculae are caused primarily by ultraviolet light damage, although there may also be associations with dust and wind exposure. They usually develop in people with a history of significant sun exposure without eye protection such as sunglasses. They are not cancerous, although cancers can develop in the same area of the surface of the eye.

 

Symptoms

Pterygia and pingueculae may be easily visible and cause cosmetic concerns. They often cause irritation, redness, and a gritty sensation. Sun, wind and dry environments, like air-conditioning, may exacerbate this.

Eventually pterygia may interfere with vision either by distorting the shape of the eye, or by extending over the pupil. Pterygia may also lead to intolerance to contact lenses.

 

Treatment

If your symptoms are mild you probably won’t need surgery. For temporary redness or irritation, eye drops or ointment can be effective. Protection from the elements (wind, dust, sea water, sunlight etc) is important; particularly wearing  a hat and UV filtering sun-glasses, when outdoors. This will reduce symptoms and prevent progression.  A doctor can remove it surgically if the growth causes discomfort or interferes with your vision.

Surgery is generally done under local anaesthetic as a day-stay procedure. The pterygium is excised from the surface of the eye, and then a graft of adjacent conjunctiva from the same eye is transplanted onto the exposed white of the eye. This is held in place with a fibrin glue. The transplant helps the eye to heal with an improved cosmetic appearance and reduces the risk of pterygium recurrence.

The procedure typically takes 30 to 45 minutes and can be performed at Oasis Surgical Centre, Ormiston Hospital or Rodney Surgical Centre. You’ll probably wear an eye patch overnight and can return to work or normal activities in a few days. Drops are prescribed, usually about four times daily for four-six weeks. The eye tends to be quite uncomfortable for a few days and does not settle completely for about a month.

 

Recurrence

Whilst pingueculum does not usually recur, pterygium may grow back. Recurrence is more likely if a person continues to be exposed to excessive levels of ultraviolet light or irritants. The recurrent growth is often more rapid than the growth of the initial pterygium, and each successive excision more difficult surgically.

 

Prevention

Try to reduce exposure to ultra-violet light by wearing wrap-around sunglasses both outdoors and in the car. This style will also give you the best protection against dust and wind. A wide brimmed hat should also be worn outdoors and lubricating eye drops can be used to keep your eyes moist in dry climates.