Eye diseases: overview of pinguecula

By Cristiano Antonino Last updated Jun 16, 2023

A pinguecula is a non-cancerous degenerative formation that forms on the conjunctiva (protective mucous membrane lining the eyeball and the inside of the eyelids)

In the initial stages, the lesion has a white colouring, which becomes yellowish in more advanced forms and, finally, in acute and chronic inflammatory phases also appears slightly protruding.

It usually forms in the white part of the eye, known as the sclera.

If caught in time, it has no effect on visual function and is merely cosmetic or may prevent the use of contact lenses.

Precisely because of its benign nature, pinguecula rarely requires specific treatment, although it can often become inflamed, causing irritation and dryness: in this case, the doctor will prescribe artificial tears to lubricate the eye and if an anti-inflammatory drug to reduce swelling.

There is a higher incidence of the condition in middle-aged or elderly people, but it can also appear in young people and even children.

In addition, people who spend a lot of time in the sun without the protection of glasses or hats are most affected.

Symptoms

Although the lesion grows in relief near the cornea, the latter is not affected unless there is degeneration into pterygium.

However, the first sign of pinguecula is the appearance of a yellowish thickening on the white part of the eye, the manifestation being more common on the side of the eye near the nose.

Other related symptoms are:

Irritation, with a sensation of a foreign body in the eye
Occasional inflammation of the conjunctiva
Itching and redness, if the area is irritated
Dry eye
Conjunctivitis
Eye pain
Eyelid swelling
Reddened eyes
Itching
Dry eyes
Eye secretion
Blurred vision

Most of these symptoms are undoubtedly typical of pinguecula, but they are not exclusive to this disorder.

It is therefore a good idea to visit an ophthalmologist if one or more of these discomforts occur for a correct diagnosis and treatment.

In some cases, the pinguecula may become swollen and inflamed, vascularised, reddened, irritated and very annoying: in this case, we speak of pingueculitis.

There are no definite causes for the occurrence of pinguecula

This lesion forms due to the disruption of normal conjunctival tissue, which accumulates protein, fat and calcium in certain places.

The reason is not known, but the onset of pinguecula is often associated with prolonged exposure to UV or infrared radiation or factors that normally irritate the eyes, such as dust, wind or particularly dry air.

Therefore, the people most affected by the disease are those who work outdoors, such as farmers and fishermen, or perform many outdoor activities.

Pinguecula can lead to the formation of a pterygium

It is a wedge-shaped growth that grows from the conjunctiva but invades the surface of the cornea.

The lesion is always benign, but in the case of a pterygium, vascularisation occurs and scar tissue forms on the eye, which can interfere with vision if it grows excessively.

In addition, a large enough pterygium can cause a distortion of the cornea, leading to astigmatism.

The transformation of pinguecula into pterygium is promoted by prolonged exposure to ultraviolet light.

Treatment of pinguecula

Normally, pinguecula does not require any treatment unless it causes severe or particularly troublesome symptoms for the patient.

However, in most cases a conservative approach is recommended and symptoms of dryness and eye irritation can be alleviated by lubrication with artificial tears, or an anti-inflammatory eye drops may be prescribed to reduce inflammation.

If, in rare cases, the growths become too large, they may interfere with vision and cause persistent discomfort: under these circumstances, the pinguecula may be surgically removed.

Generally, surgery is considered as a means of resolution when the pinguecula

Extends over the cornea (if it is large enough it may involve the central visual zone of the cornea or cause astigmatism).

It causes extreme discomfort when trying to wear contact lenses.

It is constantly and severely inflamed, even after the application of eye drops or ointments.

For aesthetic reasons.

The operation, however, is not risky: it is performed on an outpatient basis with local anaesthesia.

More annoying is the recovery: it takes several weeks during which eye drops or topical ointments must be applied several times a day.

Despite the surgical procedure, pinguecula is often recurring and tends to return: the best way to avoid a recurrence is to limit exposure to those environmental factors that facilitate its regrowth.

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