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2 Strategies To Manage Pingecula – Drops & Cosmetic Procedure

  • 4 min read

Pingecula is a yellowish white growth in the eye. It is visible to the naked eye as a raised round spherical nodule. Pingecula is present in the area between the open lids on either side of the colored part of the eye.It occurs due to pollution and UV radiation causing damge to the tissue under the top layer. Dry Eyes further augments the deterioration.

Pingecula Causes

UV Radiation is the op cause. Irritation from contact lenses, dryness and pollutants are other known factors in the development of Pingecula.

Pingecula seen on slit lamp
Pingecula seen on slit lamp

The patient usually present with irritated eyes and maybe redness. The slit lamp picture above shows the appearance. A creamy yellowish nodule with surrounding conjunctival degeneration. Sometimes there can be blood vessels. In later stages the surrounding conjunctiva becomes scaly . That is a transitional stage to pterygium.

Pingecula Vs Pterygium

Pingecula is a precursor of Pterygium. When the dying tissue cries for nutrition the body sends blood vessels to supply the needs. This is the tipping point for the avascular growth to turn into a pterygium. The Pterygium starts marching towards the cornea.

Traditionally when surgical techniques were not as well developed as today, it was taught that Pterygium should be operated only when they interfere in vision. Now with our great cosmetic outcomes using stichless methods we are not limited by such teaching. Even though medical insurances still follow this dictum we have observed that earlier intervention yields better visual and cosmetic outcomes. Many of our patients queried as to why wait wait for pingecula to turn into pterygium before surgical intervention. ON introspection and looking at data it made sense. Do we wait for blood pressure to deteriorate completely before treating it?Early blood sugar control has been shown better for Diabetes control.

Therefore we do early surgical intervention if requested.

Nodular pingecula
Pingecula left of the colored part

How Long Does Pingecula Last?

Sometimes the small nodule remains unchanged for years with proper management. At other times it can progress fast to cause problems with tear dispersion.

Pingecula Eye Drops

There are no specific eye drops for this malady. Preservative free artificial tears are helpful. Omege 3 preservative free drops are soothing. Even better is Hylo Optase eye ointment which coats the bump for many hours. If it gets irritated or inflamed a short course of steroid eye drops is beneficial.

Punctal Occluders

This is a quick office based procedure which preserves natural tears and decreases dry eyes. They may be short lasting collagen occluders which last a few weeks. These can also serve as a test to see if patient tolerates occluders. We also have synthetic biocompatible punctal plugs which slowly dissolve over many months. Initially we occlude just the lower punctum, and if needed the upper ones can also be done.

Oasis Medical produces this synthetic biocompatible inserts.

Cosmetic Pingecula Removal

If it is cosmetically unsightly it can be safely removed with modern advanced surgical technique. Insurance Industry does not cover this procedure as they feel it is a cosmetic surgery. Though we may not agree that is purely cosmetic but the end result of the procedure should be a cosmetic white eye.

The steps and the extent of the surgery would depend on the size of the lesion and if it has a vascular component or not. Therefore the cost will vary depending on whether a graft is necessary or not.

As you may infer each case is unique. That is why we offer a FREE virtual consult through facetime or zoom and review the pictures of the nodules. Please call to set up a no obligation virtual consult.