Pinguecula (pin-GWEK-yoo-lah) is a common condition of the eye in the form of a small lesion. It is typically yellowish and opaque as well as comparatively soft. These are generally harmless growths that occur on the sclera (the white of the eye) between the eyelids. The word “pinguecula” comes from the Latin term “Pinguis” which means fat. It was named so due to its resemblance to the fatty tissue of the body. Nevertheless, there is no fatty tissue in the pinguecula.

    Anatomy of the Eye

    On the outside, the external eye consists of lids and lashes. The white of the eyeball is called the sclera, this is the tougher fibrous part of the eye that protects the inner structures. The sclera is coated with a thin transparent layer called the bulbar conjunctiva that connects behind the eyelids to the palpebral conjunctiva. This layer keeps the eyes moist by regular emissions of mucous and tears.

    The cornea of the eyeball, is the convex layer that covers the iris and pupil. The iris is the colored part of the eye and the pupil black opening that can contract to control the amount of light entering the eye. The cornea directs the light coming into the eye to the retina at the back of the eyeball where it can be sent to the brain through the optic nerve. The limbus is the spot where the cornea meets the sclera.

    Location of Pinguecula

    can be found on the bulbar conjunctiva and come in a array of shapes and sizes. Most often they are round or oval but can also take on a triangular shape when located close to the limbus. Pinguecula can occur in both eyes simultaneously, but can also occur in a single eye alone. These can occur on the side next to the nose, called the nasal side, or on the opposite side of the cornea on the side next to the ear, called the temporal side.

    Mechanism of Pinguecula Formation

    Pinguecula form as a reaction to a degeneration of the inner layers of the bulbar conjunctiva, thinning in the bulbar conjunctiva and the depositions of fats and proteins. Often a pinguecula can undergo calcification.

    When the superficial layers of the conjunctiva exhibit an elastotic degeneration the result could be pinguecula. You will notice small deposits of calcium and a disposition of hyaline materials in the region affected.

    What are the Risk Factors for Development of Pinguecula?

    Those over the age of 40 are at the greatest risk of contracting pinguecula. Although it is not uncommon for younger people who live and work in a environment exposed to strong UV rays, dust or winds. For this reason, it has often been called “Farmer’s Eye”.

    –Over exposure to UV rays is a serious risk factor for people of all ages. This applies to both A rays and B rays.

    — Those living closer to the equator are subjected to more direct solar rays and are therefore at a higher risk of contracting pinguecula. The reason it is most often found on the nasal side of the cornea, is because these rays are reflected from the nose and onto the bulbar conjunctiva.

    –Males are more commonly affected by pinguecula than females, probably due to more solar exposure throughout their lives.

    — Patients with dryness of eyes or a history of contact lens use are at a higher risk of contracting pinguecula.

    –those that operate welding arcs have seen a higher rate of pinguecula due to the intense lighting.

    –Smoking, diabetes mellitus and Gaucher’s disease can increase the chances of this condition.

    What are the Signs and Symptoms of Pinguecula?

    The vast majority of people will never experience the symptoms of pinguecula.

    Being a raised bump on the surface of the eyeball, the pinguecula cause the tear film to spread unevenly. This leads to a spot in the tear film that is worn away until torn and causes dryness, irritation, redness, the sensation that there are foreign objects in the eye leading to greater rubbing and an aggravation of the condition. Blurry vision soon follows as well as more intense stinging.

    When the pinguecula becomes larger and irritated to the point of inflammation, the condition has become worse and is known as “pingueculitis”. This can cause the eye to be aesthetically pleasing as it appears very painful.

    How is Pinguecula Diagnosed?

    In a clinical facility an eye doctor will use a slit examination to study the structures of the eye. Other times, a biopsy will be taken of the pinguecula and studied for a confirmed diagnosis.

    How is Pinguecula Treated?

    Most people with pinguecula will not need any treatment. Reassurance is more than enough to make the condition livable.

    Medical management:

    If the condition is aggravated than treatment may be needed. This could include:

    — Scleral contact lenses are another option and offer protection from further UV exposure

    Pingueculitis can be another uncomfortable condition. Cold compresses can do much to reduce the redness of the condition. Steroid eye drops are another alternative and include rimexolone, loteprednol or fluorometholone. NSAIDS can also be found effective in addressing the condition. It is not recommended to use steroid containing eye drops for prolonged treatment of pinguecula.

    Surgical procedures are only recommended after all other attempts to address the condition have failed. If it interferes with the person’s vision or their capacity to wear corrective lenses, this should also be a reason to seek surgical procedures.


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