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Pterygium and pinguecula are fleshy growths on the surface of the eye. They are similar in appearance and may produce similar symptoms. However, they may be distinguished by the fact that a pinguecula develops on the membranous part (conjunctiva) that covers the white of the eye (sclera) without crossing to the cornea (the clear part of the eye near the pupil), while a pterygium usually crosses over to the cornea. A pterygium may develop from an existing pinguecula. They often develop on the side of the eye that is close to the nose. Both are noncancerous growths and are quite common.

It is not clear what causes pingueculae and pterygia to develop, but scientists believe that exposure to the sun's ultraviolet (UV) light may be an important factor in their development. Other factors involved are dry eyes and frequent exposure to wind and dust. They can affect anyone, but they commonly develop in people ages 20 to 50.

Symptoms are often mild, starting with the appearance of a yellowish or pinkish growth of a fleshy tissue from the side of the eye. Some people may experience itching and a gritty or foreign body sensation in the affected eye. Others may experience redness, burning sensation and inflammation when the growth becomes bigger. A pinguecula usually does not affect one's vision, but if it develops into a pterygium, which crosses to the cornea, it may cause astigmatism and blurring of vision.

Treatment

Many people who experience mild or no symptoms do not require treatment for either pinguecula or pterygium. However, some patients seek treatment to improve their cosmetic appearance or when their symptoms, especially blurring of vision, become bothersome.

Conservative treatment includes the use of lubricating eyedrops or eye ointment, which may contain steroids to reduce inflammation or vasoconstrictors to reduce redness. They may also be advised to use sunglasses outdoors. If symptoms persist, they may opt for minor eye surgery to have a pterygium removed.

Surgical removal of pterygium is followed by patching the empty space with a graft made from placental tissue or conjunctival tissue from one's own eye. The procedure last for less than an hour, after which patients are advised to wear an eye patch for one or two days. They must avoid rubbing their eyes or swimming during this period as the eye heals. However, they may be able to go back to work and their normal activities. Patients are also advised to use steroid eye drops for several weeks/months to reduce inflammation and to prevent recurrence of pterygium.

Patients must be warned that the most common complication of pterygium removal is recurrence.

The likelihood of developing a recurrence of pterygium is higher (up to 50%) when a graft is not used. Other possible complications include scarring of the cornea and damage to the white part of the eye. Pterygium surgery may also cause astigmatism in some cases.

After the surgery, patients must be carefully followed for a year since most recurrences occur during this period.

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