Pinguecula vs Pterygium

Causes (Shared)

• Chronic irritation from UV exposure, dust, wind, or dryness

• Common in outdoor workers or regions with high UV (tropical climates)

Pinguecula

Features

• Localised, yellowish, elevated lesion on the conjunctiva

• Does not cross the cornea

• Often located nasally or temporally

• Can become inflamed (pingueculitis) → redness, irritation

Management

• Lubricating Eye Drops for dryness/irritation

• Topical Steroids/NSAIDs for occasional inflammation

• Typically benign and asymptomatic, no surgical intervention required unless persistent irritation

Pterygium

Features

• Wing-shaped, fibrovascular tissue that crosses the cornea

• Usually arises nasally, can distort vision if it grows into the visual axis or induces astigmatism

• Can cause persistent redness, irritation, foreign body sensation

Management

• Conservative:

  • Lubricants for dryness, mild irritation

• Surgical:

  • Indicated if vision affected, significant astigmatism, or chronic irritation

  • Adjunct: Mitomycin C used intraoperatively can reduce recurrence risk

• More progressive than pinguecula; can impair vision

Prevention (Both)

• Sunglasses with UV protection (wrap-around style ideal)

• Protective Eyewear in dusty or windy conditions

• Lubricants for dry eyes if indicated

Key Differences

• Pinguecula: Confined to the conjunctiva, does not invade cornea, generally benign

• Pterygium: Extends onto the cornea, more likely to affect vision, may require surgical removal