Even though they are two different conditions, pinguecula and pterygium they are often lumped together and sometimes confused with each other. In fact, in some ways, they are similar: they both are growths that form on the ocular surface and both are more frequent in people who work in theopen air.
What are the pinguecula and pterygium?
«The first is a benign degenerative formation that grows on the conjunctiva that covers the “white of the eye” (the sclera) and rarely affects vision. However, the same cannot be said for the pterygium – the professor began Paolo Vinciguerra, head of the ophthalmology operational unit at the Humanitas Institute in Milan -. The pterygium is in fact a fibrovascular excrescence of the conjunctiva exposed to the air which however it also tends to invade the cornea, i.e. the transparent membrane placed in front of the pupil and iris, with the risk of generating astigmatism and reducing visual quality. Precisely for this reason, the pterygium must almost always be removed surgically, unless it is recognized in the initial phase.”
How do they manifest themselves?
«The pinguecula appears as a thickening of the conjunctiva in relief with a yellowish colour, typically on the nasal side of the eyeball. It can sometimes become inflamed and cause irritation and burning. The pterygium instead has the appearance of a vascularized triangle, whose tip points towards the cornea. It can cause the sensation of a foreign body and reduce the quality of vision when it invades the cornea.”
What can be done to counter them?
«The pinguecula is harmless and does not require particular treatments. It can also regress a little if the favoring factors (sun, wind, dust) are removed. If it causes annoying problems, such as irritation and dryness, artificial tears can be used. Only rarely is it removed surgically. The treatment of pterygium is essentially surgical. Only if it is discovered in the initial phase, when it has not yet invaded the cornea, can one try to block its growth with anti-inflammatoriesprotection from sun rays and therapy for dry eyes.”
What does the intervention consist of?
Pterygium surgery is generally performed under local anesthesia and does not only consist in the simple removal of this neoformation as Professor Vinciguerra explains. «If I remove the fibrovascular growth, the cornea remains irregular and therefore the victim of astigmatism. There is also a high risk of the pterygium reforming. To avoid this, after removing it, we take a flap of healthy conjunctiva, which we leave attached with a peduncle, and use it to create a sort of barrier. In practice we turn the flap, joining it to the fibrovascular conjunctiva. This way we avoid it going through degeneration again. Ideally, the next step
is to correct astigmatism, linked to the irregularity of the cornea, with excimer laser. If I only remove the pterygium there is an improvement, but if the astigmatism is not corrected and the conjunctiva flap is not inserted the resolution is not complete.”
