Pinguecula

Pinguecula (pronounced ping-GWEH-kyuh-luh) is a small, yellow-white, slightly raised patch that forms on the clear membrane (conjunctiva) covering the white of your eye, usually on the side closest to your nose. The bump represents sun- and wind-related degeneration of collagen and elastin fibers inside the tissue. Although it can look alarming, a pinguecula is benign and rarely threatens vision.1 The spot may stay tiny for life, or very slowly enlarge; in a small percentage of people it can give rise to a larger, triangular growth called a pterygium.2 Early recognition matters because simple protections—UV-blocking sunglasses, lubricating drops, and avoidance of dusty, dry environments—can keep the lesion quiet and comfortable.

Most pingueculae produce no symptoms and are discovered during a routine eye exam. When people do notice something, it is usually one or more of the following:

• Visible yellow spot or bump on the white of the eye, often nearest the nose.3
• Dryness, burning or a gritty sensation—the elevation can disrupt the normal tear film.1
• Redness and swelling when the tissue becomes inflamed, a flare-up called pingueculitis.
• Foreign-body feeling or contact-lens intolerance if the lens edge rubs the bump.4

Pain, loss of vision, or rapid growth are not typical; their presence should prompt urgent specialist review to rule out infection or other ocular surface tumors.

Researchers believe pingueculae form when chronic environmental stress alters conjunctival collagen. Key contributors include:

• Ultraviolet (UV) light exposure—outdoor work and recreation near sand, water or snow amplify reflected UV rays.5
• Dry, windy, dusty climates that mechanically irritate the ocular surface.1
• Increasing age—degenerative changes accumulate over decades.2
• Unprotected contact-lens wear and chronic eye-rub or allergy.
• Outdoor occupations (farmers, fishers, lifeguards) or high-altitude living.
• Co-existing dry-eye disease that leaves the conjunctiva less lubricated and more prone to micro-injury.6

An eye-care professional can diagnose a pinguecula in minutes:

• Slit-lamp examination reveals a slightly elevated, yellow-white mound that stops at the corneal edge, distinguishing it from a pterygium.3
• Fluorescein dye may highlight tear-film disruption and help assess dryness.
• Photography or anterior-segment OCT (optional) documents size for future comparison.
• Biopsy or referral is reserved for unusual pigmentation, rapid growth, or suspicion of conjunctival neoplasia.9

Routine eye exams—starting at school age and repeating every 1-2 years—are the best way to detect asymptomatic lesions early.

Because most pingueculae are harmless, treatment focuses on comfort and prevention:

1. Lubricating artificial tears 3-4 times daily ease dryness and foreign-body sensation.1
2. Sunglasses with 99-100 % UVA/UVB blocking wraparound lenses reduce further UV damage.5
3. Topical anti-inflammatory drops (short-course corticosteroid or ciclosporin) calm pingueculitis flares.8
4. Soft-bandage contact lenses can shield the bump in severe irritation.
5. Surgical excision—performed by a cornea specialist under local anesthesia—is reserved for persistent inflammation, cosmetic concerns, or if the lesion threatens to encroach on the cornea.7

Recurrence after removal is uncommon but possible; meticulous UV protection lowers that risk.

Day-to-day strategies can keep eyes comfortable and reduce the chance of the bump growing:

• Follow the 20-20-20 rule—every 20 minutes at a screen, look 20 feet away for 20 seconds—to stimulate blinking.
• Apply preservative-free lubricating drops during windy, dusty, or low-humidity days.4
• Wear broad-brimmed hats and quality sunglasses whenever the UV index is moderate or higher.5
• Use protective goggles for yard work, sanding, or water sports.
• Quit smoking and moderate alcohol; both can worsen ocular-surface dryness.
• Schedule annual eye exams if you are an outdoor worker or have a history of dry eye.

With these measures, most people never need surgery and may even forget the spot is there.

Scientists are exploring new ways to prevent and treat UV-related conjunctival disease:

• UV-spectrum absorbing contact-lens materials under development could shield the limbal conjunctiva more effectively than today’s lenses.7
• Anti-inflammatory nanodrop formulations aim to deliver corticosteroids only to inflamed tissue, minimizing side-effects.
• Gene-expression profiling has identified up-regulation of matrix metalloproteinases during pingueculitis, opening doors for targeted biologic therapies.6
• Smart-phone UV-exposure apps linked to wearable light sensors are being tested to reinforce sun-safety behaviors in surfers and lifeguards.
• Clinical trials supported by the National Eye Institute are evaluating whether low-dose topical ciclosporin can prevent progression from pinguecula to pterygium in high-risk populations.5

If the bump becomes red, grows toward the cornea, or interferes with contact-lens wear, the ideal provider is a cornea and external-disease specialist. These ophthalmologists have advanced microsurgical training and access to amniotic-membrane grafts, tissue-sparing lasers, and customized anti-inflammatory protocols.

How to schedule: You can ask your optometrist or primary eye doctor for a referral, but many tertiary eye centers allow self-referral. Appointment availability may vary, so consider virtual triage or second opinions through Kerbside to connect quickly with board-certified subspecialists and learn whether observation, drops, or removal is best for you.