The pingueculitis is a benign condition consisting of inflammation of a pinguecula. The most important thing is not to confuse a pinguecula with another eye condition that may have a worse prognosis. In the Dr. Nebro Clinic We have the instruments to make accurate diagnoses and we can perform surgery in those cases where it is the only recommended treatment.
What is pingueculitis?
A pinguecula is a benign tumour which appears as a whitish or yellowish roughness or elevation in the area of the conjunctiva and is usually small in size, about the equivalent of a grain of rice or a lentil.
When the pinguecula becomes inflamed, the conjunctival vessels dilate, which gives the pinguecula a red colour and is accompanied by discomfort or slight pain.
It usually affects only the conjunctiva, so it does not interfere with vision, and it forms slowly: when the patient detects the symptoms, it is likely that the pinguecula has been evolving for months before.
It may appear as a single roughness or slight bump, or it may be spread over several. It may be located on the outer side, then called temporal, as it is closer to the temporal bone, or on the inner side, then called nasal, as it is closer to the nose.
The best thing to do when we detect a lump on the surface of the eye, even if it does not bother or affect vision, is to see an ophthalmologist for a good diagnosis, for follow-up if necessary, or for treatment.
A pinguecula is often confused with a pterygium. After all, they are similar in shape and symptoms, although pterygium invades the cornea and can affect vision, which is why we insist on the need to make a good diagnosis. When a pinguecula occupies part of the cornea, it is considered a pterygium.
What causes pinguecula?
There is no clear cause, but factors that increase the chances of developing pingueculitis. These include age and dry eye syndrome. For this reason, continuous stress can be another cause of pingueculitis, as it often causes dry eyes, either as a symptom or as a side effect of some treatment drugs.
There also appears to be a link between people who have exposed their eyes to sunlight or wind without adequate protection for years and working in dusty environments, again without adequate protection.
When a pinguecula becomes inflamed we speak of pingueculitis.
Symptoms and how to detect it
There are cases of pingueculae that can be overlooked, and then it will be the ophthalmologist who detects it and proceeds to establish a treatment, although it is usual to start feeling discomfort that brings you to the professional's office.
Among them, we can highlight:
- The appearance of a lump or an extension of thickened tissue, which may have a yellowish or even reddish tinge.
- This bulging area does not hurt, although it is common for you to feel the presence of a foreign body more acutely if you have problems with dry eyes.
- There may be some eye irritation, sometimes accompanied by itching, which, together with the other symptoms, may suggest allergic processes.
- In some cases, inflammation of the conjunctiva is visible to the naked eye.
Treatment of pingueculitis
Ophthalmologists usually try the most conservative treatments first, except in cases where the pingueculitis progresses abnormally quickly and invades the cornea. These treatments are as follows:
Artificial tears
They alleviate the discomfort of the most common cases and, incidentally, reduce the risk of recurrence. Moreover, it is something that has no side effects, so it is often our first choice.
Anti-inflammatory drugs
When the conjunctiva is very inflamed or the discomfort suffered by the patient is significant, artificial tears may not be sufficient and this is when we also try anti-inflammatory medication.
Surgery
Finally, if the pinguecula continues to progress or interferes with vision, simple surgery can remove the overgrown tissue that has formed the bulge and other symptoms.
Surgery is effective, although it is advisable to protect the eyes from that moment onwards with artificial tears and sunglasses, or protective goggles if the work environment requires it, because this operation does not prevent the pingueculae from reappearing in the same area of the eye or in another area.
Anyone can suffer from pingueculitis, although there are environmental factors that accelerate its onset. In some cases, having one or more pingueculae does not cause discomfort. Then we usually treat them with artificial tears, while we check the evolution. Other times, pharmacological or surgical treatment is necessary, although the most important thing is not to confuse this benign tumour with others of greater risk. Hence the importance of a good early diagnosis, for your peace of mind and to proceed with treatment as soon as possible if you are not dealing with a simple pinguecula in the eye.
Dr. Salvador Nebro Cobos