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Pinguecula and Pterygium

By Melvin I. Roat, MD, FACS, Clinical Associate Professor of Ophthalmology;Cornea Service, Sidney Kimmel Medical College at Thomas Jefferson University;Wills Eye Hospital

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Pinguecula and pterygium are benign growths of the conjunctiva that can result from chronic actinic irritation. Both typically appear adjacent to the cornea at the 3-o’clock position, the 9-o’clock position, or both.

A pinguecula is a raised yellowish white mass within the bulbar conjunctiva, adjacent to the cornea. It does not tend to grow onto the cornea. However, it may cause irritation or cosmetic blemish and, although rarely necessary, can easily be removed.

A pterygium is a fleshy triangular growth of bulbar conjunctiva that may spread across and distort the cornea, induce astigmatism, and change the refractive power of the eye. Symptoms may include decreased vision and foreign body sensation. It is more common in hot, dry climates. To relieve symptoms caused by a pterygium, artificial tears or a short period of treatment with corticosteroid drops or ointments may be prescribed. Removal is often indicated for cosmesis, to reduce irritation, and to improve or preserve vision.

Pinguecula and Pterygium

Pinguecula and pterygium are conjunctival growths that may result from chronic actinic irritation. Pinguecula (left) is accumulation of conjunctival tissue at the nasal or temporal junction of the sclera and cornea. Pterygium (right) is conjunctival tissue that becomes vascularized, invades the cornea, and may decrease vision.

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