Pinguecula and Pterygium

A pingueculum is an elevated mass of thickened yellow tissue typically on the nasal side of the eye, commonly seen in dry, dusty and windy environments. A pterygium is a triangular shaped lesion that differs from a pingueculum in that it extends over the cornea, or colored portion of the eye. Pterygium will often become larger over time, sometimes resulting in diminished vision, particularly in younger patients. Both pterygium and pinguecula can become inflamed and irritated and although they seem similar, pinguecula rarely progress into pterygium.

A common reason for visiting the eye doctor is for the evaluation of fleshy “growths” in the corners of the eyes, often growing over the cornea. These lesions can easily become irritated, leading to redness and watering, particularly if exposed to direct sunlight, wind and dust. These lesions are twice as likely to develop in men and more common in people who work outdoors than in office workers.
Pterygium can cause diminished vision due to induced astigmatism and the physical placement of the lesion over the visual axis. Rarely, a pingueculum will precede the formation of a pterygium if the affected area is exposed to repeated irritation from sunlight, wind and dust. It is known that heredity plays a role in the formation of these lesions—they are more common in persons of Spanish and Oriental origin—although the environment plays the largest part in their development. As shown in the map below, the closer a person lives to the equator the more likely he or she is to develop pterygium. In Puerto Rico an incidence of about 18% exists, in Nevada about 10% and north of the 40th parallel less than 2%.

Lesions that appear on the cornea in atypical locations (not in the area between the lids) are often more aggressive and represent other pathologies. They are often lesions that should be evaluated by an ophthalmologist. Although these "growths" are usually benign, they can rarely represent malignancies that are typically seen on the face and body, such as melanoma and/or squamous cell carcinoma.

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