"WHAT ARE THOSE YELLOW SPOTS ON MY EYES?"
Pingueculae are localized yellowish-gray fleshy lesions that nearly always (90% of the time) appear just next to the cornea (the clear front of the eye that covers the colored part) on the white of the eye toward the nose. They may occur on the temporal (white part toward the ear) side of the eye but this is infrequent. It is also rare to find pingueculae on just one eye, as it is much more common to find it bilateral. Pterygiae, on the other hand, are diagnosed when these lesions extend ONTO the cornea. You will see this lesion actually cover up part of the colored part of your eye. There is some evidence that a pinguecula can progress to a pterygium, but most do not.
Both of these lesions are quite benign. Pterygiae, however, can grow across part of the cornea and actually obstruct vision at its worst. These lesions should be monitored by both yourself and your eye doctor in order to prevent any visual loss. Surgical excision of pterygiae is fairly successful if removed on time and is an outpatient procedure. Maybe the biggest problem with pterygium surgery is recurrence. There is anywhere from a 4 to 30% chance of a recurrence, depending on the procedure and post-op care, and depending on who you read. Pingueculae are less exciting and rarely require surgery, but if it is performed, the lesions rarely grow back.
Now, how and why do we get these little pesky bumps on our eyes, and is there anything we can do to prevent them from growing? Well…….maybe. Pterygiae have been around since 1000 B.C., according to students of Hippocrates, Galen, and others. They take their name from the Greek word meaning "wing", so we don't expect to eradicate or totally prevent these lesions anytime soon. Most researchers point to ultraviolet radiation as a major cause. Other factors include warm, dry climates, as well as loss of tear quality in the eyes. One of the largest risk factors is where you live. Prevalence is as high as 22% in equatorial areas and less than 2% in latitudes above 40 degrees. Again, this is attributable to the higher UVR (ultraviolet radiation) near the equator. There is also a significant risk for people that work outdoors in a sandy environment. For pingueculae, the jury is still out. It is unknown whether UVR is a factor in the development of these lesions.
There are several things we can do to reduce the amount of ultraviolet radiation that the eyes receive. Just wearing a hat with a large brim may reduce your exposure up to 50%. Then, the all important UV coated sunglasses are a tremendous help. Make sure any sunglass that you purchase has a label that identifies its UVR protection. Those people that are exposed to an excessive amount of REFLECTED UVR, such as on the beach, or on the ski slopes need to be particularly cautious. It is also important to keep your eyes "moist". Most of us have a good quality, natural tear, but in extraordinary environments that are windy, dusty, and dry, it is wise to supplement your own tears with one of the many good "artificial tears" that you'll find at your drugstore.
So, put on your hat, find your shades, use your moisture drops and don't sweat the small lumps and bumps.