Brief Description, Types, Sign and Symptoms, Causes And Treatment Of Pinguecula

Pinguecula (plural; pingueculae) is a degenerative condition of the conjunctiva characterized by formation of a yellowish white patch on the white part of the eye (sclera), close to the edge of the cornea (limbus). 
Although similar to a callus on skin surface, it is a degenerative change in the normal tissue resulting in deposition of fat, protein and/or calcium and is usually found on the side of the eyes closest to the nose (nasal side).

The cause of pinguecula is not exactly known but it has been considered as an age related change, occurring more commonly in middle-aged or older people who spend a lot of time in the sun, dust and/or wind. It can also be found in younger people and even children, most especially those who are often outdoors without protection such as sunglasses or hats. Hence pinguecula is believed to be caused by environmental factors, such as climate, dust and UV light because there is a high incident rate in individuals exposed to such environmental factors.

Pingueculae is considered as a precursor of pterygium and both being similar are often confused. However, pterygium grows across the cornea while pinguecula occurs only on the conjunctiva.

Signs and Symptoms

Although most people don’t really experience symptoms except when the pinguecula becomes swollen and inflamed, condition called pingueculitis. The individual may experience irritation which creates a feeling that something is in his eye (foreign body sensation). Because pinguecula does not grow across the cornea, it rarely affects vision but if it becomes a pterygium, in which case it may grow onto the cornea, vision will then be affected.

Treatment of Pinguecula

In routine no treatment is required for pinguecula. However, if so desired, it may be excised (surgical removal) and this depends on how severe the symptoms are. The surgical removal is usually considered when the pinguecula interferes with vision, contact lens wear or blinking and in the absence of this, the only remedy is management of symptoms that comes with it. In situations where the pinguacula turns into a pterygium, surgical removal may be the best course.

The best surgical option for removal of pinguecula is argon laser potocoagulation and it is preferred to traditional surgical excision because it removes the pinguecula completely with less subconjunctival hemorrhage and conjunctival scarring.

Wearing sunglasses and hats during outdoors activities can reduce the chances of developing pinguecula and any individual with pinguecula can benefit from sun protection by wearing sunglasses to prevent pingueculitis. Other symptoms such as dry eye, irritation, foreign body sensation and even pingueculitis are relieved with lubricating eye drops (artificial tear).

Steroid eye drops or non-steroidal anti-inflammatory drugs (NSAIDs) may be prescribed to relieve significant inflammation and swelling especially in severe cases.