OVERVIEW

What is pinguecula?

The palpebral fissure refers to the gap between the upper and lower eyelids, while pinguecula is a yellowish-white patch that appears at the edge of the black eyeball, most commonly on the nasal side^[1].

The pathological change of pinguecula is the deposition of protein, lipids, or calcium on the conjunctival surface.

Pinguecula generally does not cause significant discomfort or affect vision and daily life, so treatment is usually unnecessary. However, if the patient finds it cosmetically unappealing, surgical removal may be performed.

Additionally, if eye inflammation occurs, accompanied by symptoms such as redness or itching, eye drops may be used for auxiliary treatment.

Is pinguecula common?

Yes. The incidence of pinguecula ranges from 22.5% to 90% (meaning approximately 22.5 to 90 out of 100 patients have pinguecula)^[2], and it is more common in middle-aged and elderly individuals^[1].

Which department should I visit for pinguecula?

Ophthalmology.

SYMPTOMS

What are the common manifestations of pinguecula?

The common manifestation of pinguecula is the appearance of yellowish-white patches at the edge of the black eyeball, often on the side closer to the nose.

• Lesion range: Generally limited to the conjunctiva and usually does not invade the cornea.
• Lesion morphology: Mostly triangular, slightly raised patches that may gradually enlarge over a long period^[1].
• Symptoms: Most patients experience no obvious discomfort, while a few may have symptoms such as dry eyes or a foreign body sensation. If inflammation occurs, symptoms like eye redness and itching may appear.

Does pinguecula affect vision? Can it cause blindness?

Under normal circumstances, pinguecula does not affect vision and will not cause blindness. However, if it leads to severe eye infection, it may impair vision and potentially result in blindness.

CAUSES

What are the common causes of pinguecula?

The exact cause of pinguecula remains unclear, but it may be related to factors such as age and environmental exposure.

• Age factor: As people age, the conjunctiva gradually degenerates, leading to a higher incidence of pinguecula and larger lesion areas^[1].
• Environmental factors: Long-term exposure to external irritants such as dust, wind, ultraviolet radiation (e.g., welding arcs), and photochemical exposure can cause plaque formation on the bulbar conjunctiva^[1].

Who is commonly affected by pinguecula?

• Outdoor workers: Such as farmers, fishermen, and sailors, who work outdoors for extended periods and are more susceptible to irritation from dust, wind, and UV radiation, leading to pinguecula.
• Outdoor sports enthusiasts: Such as hikers, climbers, and surfers, who, like outdoor workers, are prone to external irritants and may develop pinguecula.
• People living in harsh environments: Such as those in high-altitude or desert regions, where the environment is more extreme and exposure to wind, dust, and UV radiation increases the risk of pinguecula.

Is pinguecula hereditary?

No. The occurrence of pinguecula is generally not associated with genetic factors.

DIAGNOSIS

How to diagnose pinguecula? What tests are needed?

When diagnosing pinguecula, doctors primarily rely on medical history, typical clinical manifestations, and eye examination results. The following tests are usually required:

1. Physical examination: Through visual inspection, the doctor assesses the location and morphology of the lesion in the patient's eye to preliminarily diagnose pinguecula.
2. Vision test: Evaluates the patient's vision to determine if there is any decline, ruling out other vision-impairing conditions.
3. Slit-lamp examination: Used to confirm pinguecula. Under the microscope, hyaline degeneration and elastic fiber hyperplasia in the conjunctival stroma can be observed.

Which diseases are easily confused with pinguecula? How to differentiate them?

Pterygium: Since both conditions present as triangular lesions in the palpebral fissure, pinguecula may be confused with pterygium. Doctors differentiate them through ophthalmic examinations. Pinguecula is typically confined to the conjunctiva, does not invade the cornea, and does not affect vision. In contrast, pterygium invades the cornea and can cause vision decline^[1].

TREATMENT

Can pinguecula be left untreated?

Yes. In general, if there is no concurrent ocular inflammatory reaction and it does not affect the patient's normal life, treatment is unnecessary^[3].

However, if inflammation occurs, medication such as fluorometholone eye drops or diclofenac sodium eye drops may be required.

Does pinguecula require surgical removal?

Surgical removal may be considered if the pinguecula meets the following conditions:

• Severely affects appearance and comfort;
• Recurrent inflammatory reactions such as eye redness or itching;
• Interferes with contact lens wear^[1].

DIET & LIFESTYLE

What should patients with pinguecula pay attention to in their diet?

There are no specific dietary restrictions; a normal diet is sufficient.

If eye discomfort occurs after consuming spicy or irritating foods, avoid such foods during the illness.

What are the postoperative precautions for pinguecula surgery? How to care for it?

Hygiene care: Maintain eye hygiene after surgery. Avoid getting water in the eyes for two weeks and refrain from rubbing the eyes to prevent infection^[3];
Dietary care: Maintain a light diet with balanced nutrition, increase protein and vitamin intake, and avoid spicy or irritating foods for one month^[3];
Psychological care: Stay optimistic and communicate more with family and friends;
Lifestyle care: Wear sunglasses or a hat outdoors to reduce irritation from dust, wind, and UV rays. Ensure adequate sleep and minimize screen time. Avoid using cosmetics around the eyelids^[3].
Medication care: Follow the doctor's instructions for using eye drops after surgery. Do not alter the dosage or stop medication without permission. Report any discomfort to the doctor promptly.

Do postoperative pinguecula patients need follow-up examinations? How are they conducted?

Follow-up examinations are necessary. Patients should adhere to the doctor's instructions for postoperative check-ups. Typically, the doctor will perform routine eye examinations.

PREVENTION

Can pinguecula be prevented? How to prevent it?

Since the cause of pinguecula is unclear, it is difficult to prevent, but the risk can be reduced by avoiding high-risk factors. Specific measures include the following:

1. In strong sunlight, haze, or dusty weather, take protective measures when going out, such as wearing sunglasses or a hat to protect your eyes;
2. Maintain good eye habits, avoid overuse of the eyes, and reduce the frequency of electronic device usage;
3. Pay attention to daily eye hygiene and wash your hands before touching your eyes;
4. Maintain a regular routine, choose suitable exercise, and improve immunity.