Have you ever noticed a small nodule growing on the white of your eyes near your nose? It may be colourless, yellowish or maybe a hint of grey. It can even appear on both eyes, with the size growing as the years pass by.
Then, you might be suffering from an eye disease called pinguecula. This eye disease is characterised by an elevated, external nodule and forms on the conjunctiva near the cornea. This part of the eye is called the limbus.
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Should I worry if I have pinguecula?
You need not worry because this is a benign condition that does not lead to cancer. Having this eye disease, however, may cause irritation and can make wearing contact lenses difficult. A pinguecula will not expand to cover your cornea, though it may lead to another eye disease called pterygium that can grow over the cornea and affect your eyesight. It is also important for your eye specialist to distinguish between pingeucula and other lesions / nodules on the eye, which can rarely be pre-cancerous.
Detecting and Determining the Cause of Pinguecula
Detection of this eye disease can be done through an examination by your optometrist using a slit lamp. This device is similar to a microscope. It magnifies the structure of your eye using lenses and a light source.
While the exact cause of this eye disease has yet to be pinpointed, several factors have been determined that can lead to pinguecula. Research has shown that those living in extremely dusty conditions or hot climates may be vulnerable. Those who are constantly exposed to ultraviolet rays are likewise more prone to this eye disease. Specifically, the people most likely to have pinguecula are welders, because they make use of ultraviolet rays, and farmers because they work in dusty conditions.
Prevention and Treatment of Pinguecula
The chances of avoiding pinguecula are improved if irritants, such as extended exposure to sunlight and ultraviolet rays, are avoided. If this is not possible, try to protect your eyes as much as possible by wearing a hat and a good pair of sunglasses. Go for sunglasses that can keep out as much as 99 per cent of all ultraviolet rays. Wear them constantly even after pinguecula has already formed in order to limit its growth.
You do not really need to treat this eye disease unless it develops into pterygium. Symptoms like redness and irritation may be handled by lubricating eye drops or artificial tears. Inflammation should be tackled using non-steroidal anti inflammation drops. These can be prescribed by your therapeutically-qualified optometrist or eye specialist.
Do not use eye drops with steroids unless your therapeutically-qualified optometrist prescribes them, as steroids, no matter how mild, may cause unwanted side effects. Having said that, steroid eye drops are probably the most effective non-surgical option. A two-week course of steroid eye drops that is monitored carefully by your optometrist is often the solution if other options have failed.
It is best to avoid decongestant drops containing phenylephrine (which come under many brand names such as Murine and Visine). They are also called ‘whitening’ drops as they constrict the blood vessels in the eyes and make them appear whiter. The trouble is they can cause worse inflammation once you stop using them and therefore become addictive for many users. They are usually heavily preserved, which introduces more irritants into your eyes and ultimately worsens your problem.
Surgical Treatment of Pinguecula
If you see any worsening in terms of shape, size or color, your optometrist will refer you to an ophthalmic surgeon as soon as possible to have it removed.
Surgery may be an option if the disease either worsens or if it becomes unresponsive to eye drops. This option, however, is usually only used as a last resort because, while the surgery itself is simple and painless, recovery may take several weeks. Your eye doctor may also recommend the post-surgery application of mitomycin-C, a drug used to fight cancer, to prevent pinguecula from recurring. New surgical techniques have likewise been introduced that will decrease the chance of recurrence.
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This article was originally published in Dec 2012 but has been refreshed for accuracy and relevance.