An ophthalmologist can diagnose pterygia and pingueculae through an examination using a slit-lamp (pictured at left). This device allows your ophthalmologist to closely examine the eye’s cornea, iris, lens and the space between the iris and cornea. The doctor is able to closely examine the eye in small sections, making it easier to see abnormalities.
Pterygia and pingueculae generally don’t require treatment until symptoms are severe enough. When pingueculae or pterygium become red and irritated, lubricating eyedrops or ointments or possibly a mild steroid eye drop may be used to help reduce inflammation.
If these growths become large enough to threaten sight or cause persistent discomfort, they can be removed surgically by an ophthalmologist in an outpatient procedure. They are also sometimes removed for cosmetic reasons.
For milder pterygia, a topical anesthetic can be used before surgery to numb the eye’s surface. Your eyelids will be kept open while the pterygium is surgically removed. After the procedure, which usually lasts no longer than half an hour depending on the type of surgery done to remove the pterygium, you likely will need to wear an eye patch for protection for a day or two. You should be able to return to work or normal activities the next day. Note that pterygium removal can cause astigmatism or worsen the condition in people who already have this refractive error.
After removal of the pterygium, steroid eye drops may be used for several weeks to decrease swelling and prevent regrowth.
Despite proper surgical removal, pterygium may return. In fact, the recurrence rate is between 30 and 40 percent, and is more likely among people under age 40 with significant UV exposure. To prevent regrowth after surgery, your ophthalmologist may suture or glue a piece of surface eye tissue onto the affected area. This method, called autologous conjunctival autografting, has a low recurrence rate. Medications that prevent tissue growth are sometimes used to help prevent recurrences of pinguecula or pterygium. One example of this is a medication called Mitomycin C
The best way to avoid recurrence of pinguecula or pterygium after treatment is to limit exposure to the environmental factors that contribute to their growth.