Pingueculae are non-cancerous bumps on the eyeball and typically occur on top of the middle part of the sclera — the part that’s between your eyelids and therefore is exposed to the sun. Usually pingueculae affect the surface of the sclera that’s closer to the nose, but they can occur on the outer sclera (closer to the ear) as well.
Ultraviolet radiation from the sun is the primary cause of the development of pingueculae, but frequent exposure to dust and wind also appear to be be risk factors. Dry eye disease also may be a contributing factor and can promote the growth of pingueculae.
Pingueculae are more common in middle-aged or older people who spend a lot of time in the sun. But they also can occur in younger people and even children — especially those who are often outdoors without sunglasses or hats to protect their eyes from the sun’s UV rays.
To decrease the risk of pinguecula, it’s important to wear sunglasses outdoors even on overcast and cloudy days, because the sun’s UV rays penetrate cloud cover. For the best protection, choose sunglasses with a wraparound frame design, which block more sunlight than regular frames.
Signs and Symptoms
In most people, pingueculae don’t cause many symptoms. But when they do, those symptoms usually stem from a disruption of the tear film. Because a pinguecula is a raised bump on the eyeball, the natural tear film may not spread evenly across the surface of the eye around it, causing dryness. This can cause dry eye symptoms, such as a burning sensation, stinging, itching, blurred vision and foreign body sensation.
Another symptom of pingueculae is the appearance of extra blood vessels in the conjunctiva that covers the sclera, causing red eyes.
In some cases, pingueculae can become swollen and inflamed. This is called pingueculitis. Irritation and eye redness from pingueculitis usually result from excessive exposure to sunlight, wind, dust or extremely dry conditions.
Pinguecula treatment depends on how severe the symptoms are. It’s especially important for anyone with pingueculae to protect their eyes from the sun, since it’s the sun’s harmful UV rays that causes pingueculae to develop in the first place and encourages them to keep growing.
If a pinguecula is mild but accompanied by dry eye irritation or foreign body sensation, lubricating eye drops may be prescribed to relieve symptoms. Scleral contact lenses sometimes are prescribed to cover the growth, protecting it from some of the effects of dryness or potentially from further UV exposure.
Pingueculae also can lead to localized inflammation and swelling that is sometimes treated with steroid eye drops or non-steroidal anti-inflammatory drugs (NSAIDs). If dry eye is the cause of the pinguecula, eye drops formulated to treat dry eyes also may be prescribed.
Surgical removal of a pinguecula may be considered if it becomes especially uncomfortable, if it interferes with contact lens wear or blinking or if it is cosmetically bothersome.
Finally, although a pinguecula is non-cancerous, you should report any changes in size, shape or color of any bump on your eyeball to your eye doctor.