Pinguecula is a kind of lesion on the eye – and so is pterygium. The two disorders resemble each other so much they are often mistaken for one another.
A pinguecula (plural, pingueculae) is a thick surface lump along the sclera (the white area) of the eye near its borders with the cornea. The formation is elevated slightly and appears whitish to yellowish. The pinguecula frequently grows in the palpebral fissure (the surface area dividing the upper and lower eyelids). Pinguecula appears more opaque than healthy conjunctiva (the mucous membrane coating the inner eyelid surface and the white of the eye), appears to consist of fatty substances, and has greater chances of being located closer to the nose rather than the outer corner of the eye.
Pterygium (plural, pterygia) is a triangular, wing-like lesion that actually encroaches onto the cornea, usually on the nose side of the eye and in the area continuous with the conjunctiva. It can be espied by its head – a raised, whitish, opaque tissue on the cornea. Though ordinarily not vision-threatening, severe pterygium can result in corneal blindness.
They disorders are similar in cellular/tissue structures. A pinguecula is distinguishable from a pterygium by its location in relation to the cornea and the horizontal orientation of its damaged tissues. However, a pinguecula can transform into a pterygium when it crosses over onto the cornea.
The causes of pinguecula and pterygium are not known with certainty. There is sound evidence, however, that both diseases are closely linked with chronic, long-term exposure to both blue and ultraviolet light. It is not unusual that they are generally situated around the cusp of the cornea, which is the portion with greatest exposure to sunlight. Ultraviolet radiation harms cells in the cornea and conjunctiva, especially when reserves of the protective antioxidants glutathione and astaxanthin are decreased.
Pinguecula is also linked with increasing age. Pingueculae are present in most eyes by age 70 and in practically all eyes by age 80. This is most likely a result of inevitable wearing down of the conjunctiva, as a result of aging, past inflammations, repeated irritation, and dryness of the eyes.
Pterygium has been inextricably held in tandem with patients living at latitudes of 37 degrees on both sides of the equator – which tends to bolster the linkage with UV-light exposure. Genetic links have also been suggested. Another contributor is human papilloma virus infection.
Similar to pinguecula, pterygium is believed to arise from constant presence to dust, low humidity (which can induce rapid tear evaporation and dry eyes), and tiny nicks from particles in the air such as smoke and sand. Dry eye symptoms may also be confounding factors.
Though pterygium is often understood as a deep-rooted degenerative disorder, some of its indicative characteristics suggest a proliferative growth disorder – not unlike some benign tumours. After surgery, pterygia have revealed a powerful and vigorous propensity to recur.
Pingueculae generally are quiet . You may feel a foreign body feeling from an irritated pinguecula. Very dry air quality and other environmental factors can cause inflammation and enlargement.
You usually will not sense any manifestations from pterygium. But enlarged and irritated pterygia may elicit foreign body sensation and some cosmetic misgivings about the appearance of your eyes. Enlarged or more grown pterygia, however, can induce astigmatism as it exerts pressure on your cornea.
Swelling in the pinguecula (known as pingueculitis) is very receptive to treatment with non-steroidal anti-inflammatory drugs or, if dictated, topical corticosteroids. The accompanying dry eye manifestations can be addressed with eye drops. When going outdoors, it will be prudent if you to cover your eyes from sunlight with a good pair of sunglasses. It is seldom necessary to intervene with pinguecula surgically.
A modestly-sized but enlarged pterygium may be addressed by topical corticosteroids to bring down the swelling. Dryness in the eye may be pacified with prescription eye drops.
Large pterygia may be better neutralised by surgical excision. The removal procedure is easy, but removing the possibility of return is difficult. Due to its strong tendency to recur, your doctor’s treatment program may be similar to anticancer strategies, such as wide surgical excision to uproot all possible pterygium-affected tissues, radioactive therapy, and chemotherapy with mitomycin C, an anticancer compound.
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