Learn about causes, treatments, and surgery for pingueculum.
What is a Pinguecula?
Pingueculum (ping-gwek-u-lum, plural pinguecula) is a fleshy- appearing growth that is usually found on the white of the eye, most commonly on the inner corner toward the nose. It is to be distinguished clinically from pterygium, which is a wedge shaped area of fibrosis that appears to grow into the cornea. It usually does not cause any symptoms. It is most prevalent in tropical climates and is in direct correlation with UV exposure. It may be yellow, white, gray, or colorless. It is the most commonly found “bump” on the eye. Though more common in middle-aged or older people, it can be found at any age, even in young children.
What are its causes?
The exact cause of this disorder is unknown. We do know, however, that it occurs more frequently in people who live in sunny, windy climates and in people whose jobs expose them to ultraviolet (UV) light, wind, dust or toxic vapor (for example, people who live near the equator, farmers, and arc welders). Pinguecula are very common in patients that live in Southern California.
What are the symptoms?
Most often there are no symptoms present with a pingueculum and it is solely a cosmetic concern. However, dry eye can contribute to increased irritation causing inflammation and a “foreign body” sensation. Some patients may experience pingueculitis. This is when a pingueculum can become red, swollen and inflamed. This often occurs when exposed to sunny, windy or dusty conditions.
How is pingueculum treated?
Wearing UV protecting sunglasses while outdoors is generally recommended to limit exposure to the sun, wind, and dust. Beyond this, most cases of pingueculum do not require any medical treatment. However, if redness or irritation is a concern, lubricating eye drops (“artificial tears”) are usually recommended. There are many brands, and most are available without prescription. We recommend trying different brands of lubricant drops. Many people do better with one drop than another, and experimenting is the only way to find out which drop may be best for you.
For significant inflammation and swelling, steroidal eye drops may be prescribed on a short_term basis but are generally not recommended as a long-term solution. If the pinguecula are large or interfere with a patients ability to wear contact lenses, or if the patient has cosmetic concerns, surgical removal is an option.
Many people with pinguecula are very bothered by either the appearance or discomfort from these growths and have not found relief with lubricant eye drops. In this situation, we can perform a procedure to remove the pingueculum.
When surgery is necessary, we perform this procedure in our surgery center. You'll be in our office a total of about 90 minutes, and you will need a driver because you're going to be sedated and can't drive until at least the next day.
What happens in pingueculum surgery?
You'll lie down on a gurney, and we'll give you an IV to make you completely relaxed. We'll numb around your eye while you're very sleepy, so you won't feel or see the procedure happening.
The procedure takes about 5-10 minutes to remove the pingueculum. Then we'll cover the bare area on the white part of the eye with a very thin piece of normal, healthy tissue that we remove from the upper part of the eyeball under the eyelid.
What is the chance of a pingueculum growing back?
Regrowth of pingueculum is unlikely after surgery. In our experience, this happens in less than 1% of people. This is not the case when other techniques for surgery are used. You can also reduce the chance of regrowth by wearing your sunglasses outdoors on sunny days, always and not just when you're healing.
What restrictions will I have after surgery?
After surgery, you'll go home with a patch on the eye that stays on til the next morning. Once the patch comes off, you'll begin taking eye drops that will continue for about a month. We'll ask you to avoid any heavy lifting, like more than 30 pounds, and not to take part in sports like tennis, golf, running, or biking for a week. It is ok to walk, to use a computer, and to drive a car or fly in a plane during this week, as long as you feel up to it. We ask you to avoid swimming for 2 weeks. Generally it's ok to do any activity that feels comfortable during this time, and if you're in doubt, just err on the side of caution.
Will I have pain after pingueculum surgery?
After surgery, most people have just a little discomfort during the first 24 hours. Usually, Tylenol, Advil, or aspirin will be enough, to take care of any discomfort, but just in case we'll prescribe something stronger that you can take as needed. Only 2% of our patients tell us they have anything more than mild discomfort.
What will my eye look like after pingueculum removal?
Your eye will be red after surgery, more red than it was before, and this will gradually improve over the next month or so as the eye naturally heals. In the end, it may take a few months for the eye to look its best, but most people are very pleased with the result. It's impossible to make the eye look perfect after removing this type of growth, but I won't recommend surgery if I don't think I can make a significant improvement. If you look with magnification you'll probably see some imperfection, but most people say that the appearance of the eye is completely natural after surgery.
What are the risks of pingueculum removal surgery?
There are risks to any type of surgery, including pingueculum removal. Fortunately, major complications are very unusual, occurring in about 1 in 1000 surgeries. There may be particular risks to you because of your unique eye conditions, and these will be reviewed with you during your consultation.General