Pinguecula and pterygium are both types of non-cancerous tissue overgrowth.
If a pinguecula progresses and grows into the cornea, it becomes a pterygium.
You can use over-the-counter lubrication such as artificial tears and ointments to treat symptoms.
Pinguecula occur on the whites of the eye, while pterygi form at the junction of the white of the eye and the cornea, known as the limbus.
"Most commonly, a pinguecula develops first and when it progresses and invades into the cornea, it becomes a pterygium," says Jia Yin, MD, a cornea specialist at Massachusetts Eye and Ear and professor at Harvard Medical School.
Learn more about the difference between a pinguecula and a pterygium, and what to expect if you need treatment.
What is a pinguecula?
A pinguecula is a raised yellow or white growth in the conjunctiva - the thin, transparent membrane covering the whites of the eye. They occur more frequently on the inner corner near the nose, but can also develop on the outer corner.
Both pinguecula and pterygium are thought to be caused by sun exposure and wind. These conditions are more common in people from tropical climates or those who spend a lot of time outdoors for work or leisure, says Yin.
What is a pterygium?
A pterygium is a pinguecula that extends into the clear front window of the eye or the cornea. It is often shaped like a triangular wedge, says Jodi M. Moore-Weiss, OD, an optometrist at the Mayo Clinic. While pterygium is more prevalent at the inner corner of the eye, it can grow on the outer corner as well.
Because it contains blood vessels and may also be inflamed, a pterygium may appear as a pink fleshy mass due to the blood in the tissue, Friedman says.
Pterygium is nicknamed "surfer's eye," or "farmer's eye" because both groups are exposed to strong sunlight. Water may also exacerbate the sun damage.
"Sun reflected off of the water's surface polarizes it. It actually changes the beams of the light, making it much more toxic. It's also true with snow," says Robert Friedman, MD, an ophthalmologist in private practice in New York City.
The most common symptoms of both pinguecula and pterygium include:
Sensitivity to wind
Pinguecula and pterygium are mostly asymptomatic, but sometimes they become irritated. This may feel like sand caught in the eye, accompanied by burning, itching, or tearing, says Yin. Both conditions can make wearing contact lenses difficult.
How to treat and prevent pinguecula and pterygium
Treatments for both pinguecula and pterygium are similar, including over-the-counter lubrication such as artificial tears and ointments; if used frequently it is best to seek preservative-free formulations.
"Sometimes topical steroid drops can be used for short periods if pingueculae or pterygi become very red or irritated," Yin says.
Pingueculae tend not to go away on their own, Friedman says. And "they usually worsen with time, albeit most often very slowly," Yin says. That's why it's best to focus on prevention.
The best way to prevent both conditions is to avoid too much sun and wear a hat and sunglasses - especially a pair that blocks UV rays and wraparound to protect against wind and dust when outdoors.
You can use over the counter eye drops, such as Visine, to reduce the redness associated with both conditions, says Yin. They work by constricting the blood vessels on the surface of the eye.
However, you should be careful about growing dependent on drops.
"If used for a long period of time, Visine can actually lead to rebound or chronic redness when the eye drops are stopped," Yin says. "A newer product, Lumify, is also over-the-counter and aims to reduce redness. It is a low-concentration version of a prescription glaucoma eye drop."
Yin says Lumify may reduce redness compared to Visine, but this has not yet been proven in a clinical study.
If your eyes continue to itch and you rub them, it can lead to redness and inflammation, Yin says. She recommends an allergy eye drop, usually an antihistamine, to relieve the symptoms.
Important: You should consult with your eye doctor before using any of these drops.
If a pinguecula or pterygium does not go away on its own, Friedman says it likely does not require removal unless it affects vision. He says that pingueculae do often regrow, and the rate of recurrence is 30% to 40%.
Pterygia should be controlled to limit extension into the cornea, otherwise, they can cause astigmatism, initially blurring vision, requiring glasses or contact lens correction, and potentially causing permanent damage to the cornea and vision. If prevention isn't obtained with sun and wind protection in combination with eyedrops, then surgery may be needed to reduce the risk of permanent damage.
If the pinguecula becomes inflamed, corticosteroid drops may be prescribed, says Yin. If these other options don't work, and the symptoms persist long term, surgery may be an option.
"While both of these are benign there are a few types of tumors on the eye that can look similar, so it's best to see an eye doctor for a clear diagnosis," Moore-Weiss says.
The best treatment, according to Moore-Weiss, is prevention.
"Wear sunglasses and avoid too much sun," she says.
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