"Eye Bumps" - Pinguecula and Pterygium

The most commonly encountered "bump" on the eye concerning patients is a fleshy-appearing growth called a pinguecula (ping-gwek-u-lah). They may be yellow, gray, white, or colorless. They are usually found on the white part of the eye in the space between the eyelids, almost always on the side closest to the nose. pingueculae are more common in middle-aged or older people but they can also be found in younger people and even children.

Causes

Overlying the white part of the eye (sclera) is a transparent mucous membrane called
the conjunctiva. The conjunctiva also lines the inside of the eyelids. A pinguecula is a slow growth caused by the degeneration of the conjuctiva’s collagen fibres. Thicker yellow fibres, or in some cases calcified deposits, eventually replace the original transparent fibres. In rare cases, the conjunctiva can also become red and irritated. Pingueculae can be found in one or both eyes and do not affect vision.

The exact cause or causes of this disorder is unknown, but it occurs more frequently in people who live in sunny and windy climates and people whose jobs expose them to ultraviolet (UV) light (for example, farmers and arc welders). The frequency of pingueculae increases with age lending credence to the idea that they are primarily the result of prolonged exposure to UV, infrared light and irritation.

Signs and Symptoms

There are often no symptoms of a pinguecula other than a cosmetic concern.  Dry eye can sometimes contribute to increased irritation, resulting in a "foreign-body" sensation and inflammation.

Treatment

Most people with pingueculae do not require treatment unless their symptoms are severe. Lubricating eye drops are normally recommended to relieve irritation and foreign-body sensation. Steroidal eye drops may be prescribed if significant inflammation and swelling are present. Everyone with pingueculae should wear UV-blocking sun protection to help reduce the irritation that contributes to the formation and progression of pingueculae. Surgical removal of pingueculae is sometimes considered if they are large or result in the the inability of contact lens wearers to wear their lenses.


Pterygium

A less commonly encountered "bump" on the eye is a pterygium.  A pterygium is a triangular or wing-shaped growth on the white part of the eye that also extends onto the clear front window
of the eye called the cornea. A pterygium contains blood vessels and can be of greater cosmetic concern than the typical pinguecula. In extreme cases, pterygia may grow far enough onto the cornea to interfere with vision. A pterygium can result from the progression of an initial pinguecula. As with pingueculae, prolonged exposure to ultraviolet, wind and dry conditions seem to play a significant role.

Symptoms