A yellowish change on the white part of the eye (conjunctiva) is often a localized, non-infectious growth that develops over time, typically in response to environmental factors. The two most common forms of these growths have similar names but distinct characteristics and potential impacts on eye health. While visible, these conditions are generally benign and manageable.
Pinguecula: The Benign Yellow Spot
A pinguecula appears as a yellowish, slightly raised patch on the conjunctiva. This growth is a localized deposit of protein, fat, or calcium, representing tissue degeneration. Pingueculae commonly form on the side of the eye closest to the nose. The defining feature is that it remains stationary and does not grow onto the cornea. When the growth becomes inflamed (pingueculitis), the area appears red and swollen, often in response to dry air, dust, or excessive wind exposure.
Pterygium: The Growth That Spreads
In contrast, a pterygium is a fleshy, wedge-shaped growth of the conjunctiva that is distinct because it grows onto the cornea. This growth is often triangular, may be pink or yellowish, and typically contains visible blood vessels. Its progression onto the cornea is the key difference, sometimes earning it the nickname “surfer’s eye.” As the pterygium advances, it can begin to affect vision. The growth can physically obstruct the visual axis if it reaches the pupil, or it can cause a change in the shape of the cornea, which induces astigmatism.
Environmental Causes and Risk Factors
The primary cause for the development of both pinguecula and pterygium is chronic, long-term exposure to ultraviolet (UV) radiation from the sun. UV light damages the conjunctival tissue, triggering the degenerative changes that result in these growths. Consequently, these conditions are more prevalent in individuals who live in sunny climates or spend extended periods outdoors without protection. Secondary environmental factors also contribute significantly to irritation, including exposure to wind, dust, sand, and other airborne irritants. Chronic dry eye is another contributing factor, as inadequate tear film lubrication exacerbates the irritation caused by environmental exposure.
Management and When Professional Care is Needed
Initial Management
Initial management focuses on alleviating symptoms and reducing inflammation. Mild symptoms like dryness or the foreign body sensation are effectively treated with over-the-counter artificial tears for lubrication. If the growth becomes significantly red and inflamed, an eye care professional may prescribe mild steroid or non-steroidal anti-inflammatory eye drops to reduce swelling.
Prevention
Prevention is fundamental to managing these conditions and preventing progression. Wearing UV-protective wrap-around sunglasses is highly recommended to block both direct and peripheral UV rays. A wide-brimmed hat provides additional protection, and protective eyewear should be used in windy or dusty environments.
Surgical Intervention
Surgical removal is rarely necessary for a pinguecula, usually reserved for severe, chronic irritation unresponsive to drops or for cosmetic concerns. For a pterygium, surgery is more common if the growth interferes with vision, causes unmanageable discomfort, or significantly alters the cornea’s curvature. The procedure involves excising the growth and often includes placing a conjunctival autograft to help prevent recurrence.