Pinguecula and Pterygium (surfer’s eye) -Diagnosis and Treatment

Pinguecula and Pterygium are abnormal growths of the conjunctivital tissue that can cause vision loss. Treatment options include surgery.

PINGUECULA and PTERYGIUM:

Pinguecula and Pterygium are basically growths on the conjunctiva (the clear covering over the white part of the eye) that may result from chronic actinic irritation.

Pinguecula (left) is the accumulation of conjunctivital tissue at the nasal or temporal junction of the sclera and cornea.  It is a yellowish raised, non-cancerous growth on the conjunctiva, usually on the side of the eye near the nose. It is a deposit of proteins, fats or calcium.

Pterygium is conjunctivital tissue that becomes vascularized , invades the cornea and may decrease the vision. It is basically the growth of a fleshy tissue and can start as a Pinguecula. The size of this growth is variable. It might remain small or grow large enough to cover the part of the cornea of your eye. It only interferes with vision if the growth becomes too large. The shape of Pterygium is similar to that of a wedge.

CAUSES OF PINGUECULA AND PTERYGIUM:

PINGUECULA:

A Pinguecula is caused when the tissue in your conjunctiva experiences some unusual changes and forms a small bump containing fats, calcium etc. These changes can be due to any of the reasons like: irritation caused by sun exposure, dust, and wind etc. In some people, Pinguecula develops as a result of the aging process as well. Studies show that people who live near the equator are more prone to develop, such type of growth due to the strong exposure to the sun.

PTERYGIUM:

The experts and researchers are still working to find the exact cause behind Pterygium. However, Pterygium seems to result from long and direct exposure to UV rays emitted by the sun. People who sit in the sun for long, belong to places with extremely warm climate with most of the days being sunny, are more prone to developing this kind of conjunctivital growth in their eyes.

In addition to this, people who experience regular exposure to elements such as pollen, smoke, sand etc. are comparatively at a higher risk of developing this condition.

SYMPTOMS OF PINGUECULA AND PTERYGIUM:

Both pinguecula and pterygium have nearly the same symptoms.

Specialists say that although, such type of growths do not show symptoms in most of the cases. In case they do, some common and serious symptoms include:

Redness of the eye:

Redness in the eyes occurs when the blood vessels inside the eye become swollen. Due to this abnormal growth, the eye vessels get irritated and hence start swelling up. This swelling causes redness in the eyes. If the redness lasts longer than a week, you should immediately consult a good eye specialist.

Blurred vision:

The extra tissue growth in your eyes disrupts your normal vision and hence the entire line of your sight (including your peripheral and field vision) tends to become blurred.

Burning sensation:

People with such abnormal growth in the conjunctivital tissue feel burning sensation followed by itching in their eyes.

Eye irritation:

Irritation in the eyes is caused when the eyes detect or feel the sensation of some foreign substance. The growth in the conjunctivital tissue of the eye is abnormal and the eyes are not used to it. Hence, the eyes suspect it to be a foreign growth or substance.

Vision disturbance:

In most cases, when the body shows symptoms, the vision of the person becomes blurred. In some rare cases, the vision might get “completely interrupted” because of the large size of tissue growth.

Difficulty in using contact lenses:

People with pterygium in their eyes might find it quite difficult to apply contact lenses to their eyes. The growth in the tissue might hinder the contact lens from sticking to the eye. If you ever feel such type of difficulty in using contact lenses, you should immediately see an eye doctor.

Sensation of a foreign substance:

If the pinguecula or pterygium grow in size, they might prove disturbing. Our eyes might treat the growth as a foreign substance because they are not used to it.  The sensation of a foreign substance causes itching and irritation in the eyes.

DIAGNOSIS OF PINGUECULA AND PTERYGIUM :

Pinguecula and pterygium are two different conditions but the process of their diagnosis is almost the same.

Diagnosis of pinguecula and pterygium is straightforward and does not involve a wide variety of steps. The eye doctor may diagnose this condition based on a physical examination using a slit lamp. This slit lamp allows the doctor to see your eye with the help of magnification and bright lighting, and hence find out if there is an extra growth in the conjunctivital tissue.

 If the doctor feels the need to do additional tests, he may go for:

  • Visual acuity test: This is a test that checks how well the patient can see and identify symbols, letters and numbers printed on a chart kept at sufficient distance from him.
  • Corneal topography. Corneal topography is a computer assisted diagnostic tool that creates a 3-D medical map of the surface curvature of the cornea inside the eye. Studying this map, the doctor can check for the conjunctivital growth.

TREATMENT:

Generally, there is no need to go for any type of treatment for pinguecula and pterygium.

For minor cases in which the patient feels little discomfort in the eyes, the doctor can prescribe certain eye drops or ointment that contain corticosteroids to treat inflammation.

After having diagnosed the patient’s eye for pinguecula or pterygium, the doctor might look into the seriousness of the condition. The tissue growth can easily be resolved using eye drops and does not require much treatment. Moreover, if the size of the growth is small, it does not disturb the vision of the person. To monitor the growth, the doctor should ask the patient to pay regular visits without fail.

In more serious cases, treatment can involve surgery to remove the extra growth in the conjunctivital tissue.

Surgery can also be suggested and carried out by the doctor if:

  • The appearance of the growth bothers the patient.
  • the eye drops and medicines do not provide much relief
  • the abnormality starts leading to vision loss in the patient

Although the surgical method is the most effective one, there are a couple of risks associated with such type of operations:

  1. Even after removing the grown tissue surgically, there are chances of it growing back.
  2. The after effects of the surgery can include dryness and irritation in the eyes.

To overcome both of the above problems, the doctor might prescribe some medicines or eye drops (eg. – artificial tears) that will keep the eyes lubricated and hence reduce the irritation. The medicines will also help to reduce the chances of the abnormality growing back.

In some rare cases, Pterygium can lead to severe scarring on your cornea. Scarring on the cornea is dangerous and needs to be treated because it can cause complete vision loss.

Apart from the medical treatment, the patient should make sure that he protects himself from direct exposure of the UV rays of the sun. Wearing sunglasses or hat when going outside, in the sun can be helpful in preventing further growth.

The best way to treat your eyes is to visit your eye care professional and get your eyes checked regularly. He will be able to assess the best method of treatment for your eye ailment.

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