Pinguecula

Question 1

Aetiology

Answer 1

Elastotic degeneration of conjunctiva - white yellow raised lesion within the palpebral aperture, usually nasally, usually bilateral

Question 2

Predisposing factors

Answer 2

Age
Males
Long term UV exposure - sunlight, welding
Chronic exposure to wind or dust
CL wear

Question 3

Symptoms

Answer 3

Asymptomatic
Sometimes FB sensation, redness if inflamed
Cosmetic concerns

Question 4

Signs

Answer 4

Area of conjunctival thickening horizontal to the limbus
Elevated and less transparent, more hyperaemia than rest of conjunctiva
White/yellow lesion, fat-like appearance, surrounding calcification
May become inflamed - pingueculitis
Dellen formation
Reduced TBUT

Question 5

Non-pharmacological management

Answer 5

Reassure of benign nature
Cold compresses when inflamed
Reduce UV exposure - wear sunglasses or brimmed hats when outdoor

Question 6

pharmacological management

Answer 6

Lubricants and ointments when irritated
Short course of steroid when inflamed

Question 7

refer?

Answer 7

Usually not needed but routine if significant cosmetic concern - can be removed with excision using conjunctival autografting, or argon laser photocoagulation