Pterygium & Pinguecula Surgery
Dr. Cavanaugh routinely treats patients with eye conditions such as pterygia and pingueculae
Funny Names: What are They?
A pterygium is a wedge-shaped fibrovascular growth of conjunctiva (the surface tissue of the white of the eye) that extends onto the cornea. Pterygia are benign lesions that can be found on either side of the cornea. Prolonged exposure to ultraviolet light contributes to the formation of pterygia. Pterygia are more often seen in people from southern or tropical climates, but can be found in others as well. Like sun damage to skin, Pterygium often take many years of cumulative sun exposure to develop and do not come on instantly.
Pingueculae are yellowish, slightly raised lesions that form on the surface tissue of the white part of your eye (sclera) close to the edge of the cornea. They are typically found in the open space between your eyelids which also happens to be the area exposed to the sun. While pingueculae are more common in middle-aged or older people who spend significant amounts of time in the sun, they can also be found in younger people and even children — especially those who spend a lot of time in the sun without protection such as sunglasses or hats.
Pterygium / Pinguecula Symptoms
Pterygia & pingueculae are often asymptomatic, and many do not require immediate treatment. However, both conditions can become red and inflamed from time to time. Large or thick pterygia / pingueculae may bother some people due to a persistent foreign body sensation in the eye. As a pterygium progresses, it can begin to affect the curvature of your cornea and in turn lead to blurry vision.
Pterygium / Pinguecula Treatment
Treatment depends largely on the size and extent of the pterygium, as well as its tendency for recurrent inflammation. Evaluation by Dr. Cavanaugh will help determine the most optimal treatment in each case. If a pterygium is small but becomes intermittently inflamed, your doctor may recommend a trial of a mild steroid eye drop during acute inflammatory flares. In some cases, Dr. Cavanaugh may recommend surgical removal of the tissue.
The recommendation for removal will likely be advised if the pterygium is growing far enough onto the cornea to threaten your line of vision. A pterygium may also be removed if it causes a persistent foreign body sensation in the eye, or if it is constantly inflamed and irritating. In addition, some pterygia grow onto the cornea in such a way that they can pull on the surface of the cornea and change the refractive properties of the eye, causing astigmatism. Removing the pterygium may decrease the astigmatism.
The removal may take place in a procedure room or operating room setting. The pterygium is carefully dissected away. In order to prevent regrowth of the pterygium, Dr. Cavanaugh may remove some of the surface tissue of the same eye (conjunctiva) and suture it into the bed of the excised pterygium. Also, an anti-metabolite such as Mitomycin-C may be applied to the site. Postoperatively, your doctor may recommend some steroid eye drops for several weeks to decrease the inflammation and prevent regrowth of the pterygium.
Pinguecula treatment depends on severity of symptoms. Everyone with pingueculae can benefit from sun protection for their eyes. Lubricating eye drops may be prescribed for those with mild pingueculitis to relieve dry eye irritation and foreign-body sensation, whereas steroid eye drops or nonsteroidal anti-inflammatory drugs may be needed to relieve significant inflammation and swelling.
Surgical removal of the pinguecula may be considered in severe cases where there is interference with vision, contact lens wear, or blinking. Frequently, pingueculae can lead to the formation of pterygia.