Pinguecula

Eye showing inflamed pinguecula

Pinguecula refers to a non-cancerous growth which forms underneath the eye’s conjunctiva. The term is taken from the Greek language denoting fat. In truth, the spot is not made up of fat but of fibrous tissue. Lesions can be oval in shape and may appear yellowish-white or grayish in color. The term should not be confused with the pterygia lesion. A pinguecula forms on the sclera, the white portion of the eye, while a pterygia forms on the cornea or on the area that covers the iris.

There is no definite cause for the growth although there are factors which can make individuals more prone to developing the lesion. Individuals living in tropical or subtropical areas or extended exposure to ultraviolet light, wind or dust particles can raise the risk of developing pinguecula. Pinguecula is also more common among the elderly, occurring in almost all individuals over the age of 80. Wearing sunglasses and avoiding known eye irritants may help reduce the chances but are not known to prevent pinguecula from forming. Individuals may opt to have surgery for aesthetic purposes or if they are experiencing distress. Surgery is recommended if the condition does not improve with using medication, if the lesion changes in terms of its size, shape or even color or if the lesion starts to affect vision.

Before any surgery begins, epinephrine and lidocaine are topically applied to the eye, ensuring that the patient does not feel anything while the surgery is being performed. After anchoring the eye using traction sutures, part of the conjunctiva is cut off using forceps and surgical scissors to allow access to the lesion. The pinguecula and other damaged tissues are removed, taking care that the cornea and semilunar fold are not damaged. Cellulose sponge with Mitomycin C (MMC) is placed around the corners of the exposed area of the conjunctiva for a few seconds to absorb excess liquid. A clear material known as amniotic membrane (AM) is then placed over the exposed area sticky side down and attached using fibrin glue. The edges of the AM are trimmed to fit the conjunctiva, ensuring a smooth transition between the conjunctiva and the material.

The actual process of removing the pinguecula is painless and quick. In most cases, procedure lasts no more than half an hour. Patients can choose to go home within several hours after the surgery is completed. An eye patch must be worn over the eye for at least a day or two to protect the eye while it is healing. The doctor may also prescribe contact lenses to be worn and taking medications for a week. Patients may return to their usual routine a day after it is removed.

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