Many people come to our office inquiring during their eye exam about an “eye bump” that they have noticed. They can be different colors, inflamed, non-inflamed and just annoying. The most common eye bump is called a pinguecula (ping-qwek-u-lah). It is a fleshy looking bump that forms at either the 3 or 9 o’clock position on the white of the eye. Usually the nasal bump is more prevalent. They can be clear, white, yellowish and vary in size. If they get inflamed, they become red and sensitive. They are more common as we get older.
The white of the eye (sclera) is covered by a clear membrane called the conjunctiva. When the transparent collagen fibers in the conjunctiva are damaged by UV, infrared rays and wind, the fibers can change into more yellow colored, and sometimes calcified fibers in the area of damage. These damaged fibers now form the bump on the conjunctiva called a pinguecula.
The people, who have more exposure to these elements, for example farmers and welders or anyone who works outside without proper eye protection, are more likely to form the bumps. Usually the nasal location is more common due to the reflection of the rays off of the skin by the nose and concentrating on the area adjacent to the iris and cornea.
Signs and Symptoms
Often, there are no symptoms with a pinguecula other than a concern of the area and the appearance of the bump. Sometimes, there is a dry and /or irritated feeling and occasionally redness.
There usually is no need to treat pingueculas. Due to the fact that the bump is raised and tears shed off of the area first, irritation can occur. If there is irritation, eye lubricant drops can be added several times a day to soothe the irritation. If there is inflammation and redness, a steroid drop can be prescribed by your eye doctor to calm the inflammation. Rarely is surgery required, the only occasion this would arise if the bump interfered a with contact lens wearer, thus interfering with their ability to wear their lenses.
A pterygium is a triangular shaped fleshy colored growth that extends from the sclera to the clear dome of the eye, the cornea. It can be varying in color from mostly white to pink to red. Pterygiums contain blood vessels that are more prevalent than in pingueculas. They vary in size from just approaching the cornea to extending midway onto the cornea. The more the growth extends on the cornea, the greater the chance of causing astigmatism and interfering with ones vision.
Often there are no symptoms with pterygiums. A dry eye sensation and irritation can arise from the elevation of the growth. Eye drops can provide relief and soothe the area. As with pingueculas, sometimes an ocular steroid drop will be used to calm the inflammation. Sometimes, eye surgery is required if the pterygium progresses far enough onto the cornea, and affecting a patients vision and comfort. Unfortunately, pterygiums have a high rate of reoccurrence; up to 50%.and healing time takes several weeks. New methods using an application of a membrane can minimize discomfort while improving outcomes and decreasing reoccurrences.
There have been no definite preventative measures to avoid getting these bumps. But the prevalence of the bumps occurring more with people more UV, wind, and other environmental exposure, suggests that sunglasses and protective eyewear are strongly recommended. The American Optometric Association recommends sunglasses that block 99% of UVA and UVB rays. Patients should consult with their eye doctors and optometrists about coatings and tints that are on sunglasses and those that can be added to there prescription glasses to protect their eyes. Protecting your eyes from sun exposure, wind, dust, and other environmental factors, is a great way to ensure eye comfort and health.
1. National Eye Institute
2. American Optometric Association
Author: Dr. Ruth Scholten-Lellbach
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All About Eyecare, P.C.
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