A pinguecula is a common type of conjunctival degeneration in the eye.

It appears as a yellow-white deposit on the conjunctiva adjacent to the limbus.

The limbus is the junction between the cornea and sclera.

It is to be distinguished from a pterygium, which is a wedge shaped area of fibrosis that may grow onto the cornea.

Usually does not cause any symptoms.

It is most common in tropical climates and has a direct correlation with UV exposure.

Commonly occurring lesion. generally small and asymptomatic raised nodules appearing on the bulbar surface of the conjunctiva.

Often yellow in appearance.

More commonly on the nasal side, but can present either on the temporal conjunctiva or on both the nasal and temporal conjunctiva in the eyes of some patients.

Thought to be associated with sunlight exposure in susceptible individuals.

Pingueculae occasionally subject to some inflammation with symptoms of itching, burning, or mild pain.

If mildly symptomatic, it can be treated with artificial tears.

On rare occasions, ocular anti-inflammatory drops may be required.

Rarely, surgical excision may be of benefit.

Histopathologically shows mild-to-moderate focal thickening of the conjunctival stroma with elastotic degeneration of collagen fibers of the conjunctival stroma with thinning of the overlying epithelium and occasionally calcification.

Actinic exposure of the thin conjunctival tissue causes fibroblasts to produce more elastin fibers, and may lead to the degradation of the collagen fibers, or sub-epithelial collagen fibers undergo degradation and assume the qualities of elastic tissue.

The high reflexion of the white scleral tissue underlying the conjunctival tissue may result in additional UV exposure to the back side of the tissue.

The side of the nose also reflects sunlight on to the conjunctiva, so that pingueculae tend to occur more often on the nasal side of the eye.

While most pingueculae are found in people over the age of 40, they are not uncommon in 20- and 30-year-old adults who spend significant time in the sun.

The surface of the conjunctival tissue overlying a pinguecula interferes with the normal spreading of the tear film.

The tear ferning test reveals abnormalities of the mucous component of the tear film, making it useful as a predictor of a person’s tolerance of hydrophilic soft contact lenses.

Contact lens intolerance can also result from the elevation of the peripheral edge of the contact lens if it overlies a pinguecula.

Pingueculae may enlarge slowly over time.

It is a benign condition, usually requiring no treatment.

Artificial tears may help to relieve discomfort, if it occurs.

Surgical excision is sometimes done for cosmetic reasons.

Occasionally, may become inflamed-pingueculitis.

The cause of pingueculitis is unknown, and it may be treated with an anti-inflammatory agent, such as prednisolone drops.

May have an increased prevalence in Gaucher’s disease.

Leave a Reply

Your email address will not be published. Required fields are marked *