Diseases of the ocular conjunctiva: what are pinguecula and pterygium and how to treat them

By Cristiano Antonino Last updated Apr 21, 2023

Pinguecula and pterygium are excrescences of the conjunctiva, the transparent lining of the sclera, or white part of the eye

Pinguecula and pterygium

Pinguecula and pterygium are both caused by exposure to ultraviolet (UV) radiation and worsened by chronic dryness or irritation.

However, there are some important differences between the two.

A pinguecula is a small, raised, white or yellow excrescence confined to the conjunctiva; it may occur on the inner or outer side of the eye.

The pinguecula may contain deposits of protein, fat or calcium

For most people it does not affect vision, but in severe cases it can interfere with the way tears cover the eye, causing dryness, redness and inflammation.

Pterygium, also known as surfer’s eye, is a wedge-shaped growth of the conjunctiva that extends over the cornea, the outer layer of the eye.

These growths can also occur on both sides of the eye.

In some cases they remain small, but can potentially grow to the point of discomfort or impairment of vision.

Pterygial growths usually cause irritation, redness or the feeling of having something in the eye and sometimes cause decreased or distorted vision after changing the shape of the cornea.

Diagnosis of pinguecula and pterygium

Pinguecula and pterygium can be diagnosed with a slit-lamp test by the ophthalmologist.

In some cases, the growth must be removed and then examined under a microscope to make a diagnosis, as some precancerous growths may appear similar to pinguecula or pterygium.

Prevention of pinguecula and pterygium

Protecting the eyes from UV rays helps protect not only the surface of the eye, but also the tissues inside the eye that may be sensitive to UV rays.

Wearing sunglasses that specifically block UV rays during daylight hours helps prevent exposure.

Keep the eyes lubricated to retain moisture and limit the effects of wind, dust and particles in the environment.

Artificial tears can be helpful.

If you use artificial tears more than four times a day, consider preservative-free formulations, which are gentler on the frontal layers of the eye.

Treatment of pinguecula and pterygium

In the early stages, pinguecula and pterygium can often be treated with artificial tears if the eye is slightly irritated.

The doctor may suggest removal of the pinguecula or pterygium if the growth

becomes thickened and painful
affects the way the eye blinks
alters the curvature of the cornea.

The ophthalmologist may encourage the use of prescription eye drops or recommend surgical removal of the growth if it appears to be a more serious lesion.

Pterygium surgery

Pterygium surgery is a procedure in which the excrescence is removed from the eye in the operating theatre.

Depending on the affected part of the eye and the health of the surrounding tissues, the doctor may move some conjunctiva from healthy parts of the eye to cover the affected area.

If the outgrowth is large, a supporting tissue called amniotic membrane may be applied to promote healing of the area.

The procedure often takes between 30 minutes and an hour.

If surgery is needed for both eyes, the procedures are usually performed on separate days to allow you to see out of one eye while the operated eye is healing.

Recovery from pterygium surgery

The doctor may apply a patch to the repaired eye to minimise residual bleeding and protect against infection.

During recovery, minor redness, irritation or blurred vision may occur.

Recovery lasts at least a month, during which time antibiotic and steroid drops are likely to be prescribed to prevent infection and reduce dryness and inflammation.

In a small percentage of cases, the growth may recur months or years later.

In such a case, surgery can be repeated and the surgeon can use additional approaches to prevent recurrence.