Pinguecula
Background
- Benign scleral growth
- Mass of collagen degeneration and fibroblastic proliferation
- Can begin on the temporal or nasal side of the cornea. More commonly develops on the nasal side.
Risk factors
- Sunlight (UV) exposure
- Windy, sandy and dusty environments
- More common near the equator
Clinical Features
- Triangular visible white-colored mass on the sclera
- Foreign body sensation with irritation, pruritus, tearing, dryness
- Does not cross the limbus or enter the visual axis (Differentiates Pinguecula from a Pterygium)
Differential Diagnosis
Ocular Diagnoses
- Acute angle-closure glaucoma
- Conjunctival abrasion
- Corneal foreign body
- Corneal ulcer
- Episcleritis
- Painful eyes with normal exam
- Pterygium
- Scleritis
- Traumatic hyphema
- Uveitis
- Pinguecula
Evaluation
- Clinical diagnosis, based on history and physical exam
Management
- UV Protection
- Lubricating eye drops
- Naphazoline/ketorolac (NSAID) drops (if symptomatic)
Disposition
- Discharge with non-emergent ophthalmology follow-up