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Pinguecula and pterygium
These lesions 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 (see Pinguecula and Pterygium ).
A pinguecula is a raised yellowish white mass on 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. Removal is often indicated for cosmesis, to reduce irritation, and to improve or preserve vision.
Subconjunctival hemorrhages
These extravasations of blood beneath the conjunctiva usually result from minor trauma, straining, sneezing, or coughing; rarely, they occur spontaneously. The extent and location of hyperemia can help determine etiology. Diffuse hyperemia of the bulbar and tarsal conjunctivae is typical of conjunctivitis. Subconjunctival hemorrhages alarm the patient but are of no pathologic significance except when associated with blood dyscrasia, which is rare, or other facial or ocular injuries. They are absorbed spontaneously, usually within 2 wk. Topical corticosteroids, antibiotics, vasoconstrictors, and compresses do not speed reabsorption; reassurance is adequate therapy.
Last full review/revision June 2008 by Mitchell H. Friedlaender, MD
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