Pingueculitis – Why It Happens And How It Is Treated?

Pingueculitis is painful eye infection that can threaten your eyesight if left untreated.

Many people do not realize that they are at risk for this illness until they develop the uncomfortable symptoms.

While this disease can cause a great deal of discomfort and fear, it can be successfully treated if you understand what to do and when to seek medical care.

tired eyes

What Is Pingueculitis?

Many people develop a pingueculum, a yellowish bump on the eye, at some point in their lives.(1)

The plural of a pingueculum is pinguecula. Many of these growths are round or cone shaped. They are usually located on the inner part of the eye, which is the side nearest your nose.

These pinguecula occur on the white of the eye, which is also called the conjunctiva or sclera.

Many people have pinguecula because these develop from exposure to the sun, wind, dust, and other irritants. The extra tissue that makes up the growth is formed by elastin and collagen fibers that have built up as a result of the stress on delicate eye tissues.

Pinguecula are similar to another eye condition called a pterygium.

However, pinguecula usually occurs only on the conjunctiva of the eye, and usually on only the medial part of the eye near the nose.

Pterygia, on the other hand, grow into the cornea and thus can obstruct vision unless removed. Both of these eye conditions are benign, or non-cancerous, and both are due to exposure to the sun and other elements.

Both eye conditions can be diagnosed with a simple eye exam; there is no need for biopsies or other painful tests.(2) It is very rare for a pingueculum to become a pterygium, as these usually do not grow on the cornea.

Most pinguecula never develops any kind of inflammation or infection.

They are usually not noticeable at first, so some people may not even realize that they have them. However, these sometimes become inflamed or infected. This is especially true if the pingueculum is very raised or bumpy rather than flat.

When this happens, it is called pingueculitis. This condition may be rare, but it can have devastating effects on your vision if not promptly treated.

Having a pingueculum is very common, affecting around ten percent of people. An infection or inflammation of these pinguecula, called pingueculitis, is less common. People who have conditions such as chronic kidney disease are more likely to develop this problem, although doctors do not fully understand why.(3)

Older people also are more likely to have pinguecula, with almost all people over the age of eighty years having them.(4)

 

Symptoms

eye close upThe following symptoms indicate that you may have pingueculitis and need to get medical care:

» Feeling that there is something in your eye

» Pinkness or redness in your eye near your pinguecula

» A feeling of heat or warmth coming from the eye

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» More watering than usual, or even discharge

» Alternately, extremely dry or gritty feeling eyes

» Swelling of the affected eye or the tissues around the eye

» Systemic symptoms of infection such as a fever or chills

» Blurriness or other changes in vision

» Pain with blinking or otherwise moving the eye

» Difficulty moving or focusing eyes that come on suddenly

» Headaches, especially on the same side as the eye inflammation

These symptoms can occur with any infection of the eye. The main difference is that with pingueculitis, they will occur in the region where there is an existing pinguecula.

It is important to get immediate medical care and treatment for any kind of eye infection. The tissues of the eye are easily damaged, which can mean lifelong changes in sight or even loss of vision.

 

Treatment Options

A tablespoon of drugsThere are several options for treatment of pingueculitis. Your doctor can explain which of these are best for your unique situation. It is important to follow your treatment plan as closely as possible so you can recover completely and have fewer side effects.

First, you may need to use antibiotics in the form of eye drops, ointment, or pills for some time. These will help if your infection is bacterial, rather than viral or fungal in nature.

Depending on your type of infection and your medical history, this could include antibiotics such as;

» aminoglycosides

» chloramphenicol

» or a fluoroquinolone such as besifloxacin

Doctors also recommend that eyes with pingueculitis be kept moist using lubricating drops. Your doctor may give you lubricating eye drops that contain steroids if your eye is very swollen or irritated.

Steroid eye drops reduce inflammation, preventing both pain and destruction of tissues.

In addition, people with pingueculitis need to make certain lifestyle changes to keep this infection from occurring again. They should avoid sun, wind, and dry air during treatment to allow their eyes to heal.

They may also need to avoid these elements after treatment to prevent a recurrence. Simple changes such as wearing sunglasses and using over-the-counter lubricating eye drops regularly can prevent a recurrence of this infection.

If your pingueculitis is severe, disrupts your vision, or is likely to recur, your doctor may recommend surgery to remove the pinguecula entirely.(5)

This can be done without damaging or leaving a scar on other parts of your eye. Most people do not have to stay in the hospital or go under general anesthesia when they have this procedure performed.

Many doctors will not perform this surgery on people who do not have symptoms from their pinguecula due to the high rate of recurrence.

 

What to Do If You Think You Have Pingueculitis

If you have a pingueculum, there are several ways that you can reduce the chances of it becoming inflamed.

First, avoid sun, wind, dust, and other elements that irritate your eyes. These can make your pingueculum grow or even cause more of them to form, both of which will lead to more symptoms while also increasing your chances of developing pingueculitis.

Wearing sunglasses that cover your eyes well and have UV protection is often sufficient protection to prevent this condition from worsening.

Keeping your eyes moist is also important if you have a pingueculum or pingueculitis.(6)

This reduces the friction of blinking and moving your eye normally, again reducing pain, inflammation, and infection. Your eyes will be healthier ad less likely to develop pingueculitis if they stay moist.

 

When to See a Doctor

doctors and patient discussingIf you have signs and symptoms of pingueculitis or any other infection of the eye, it is important to see a doctor as soon as possible.

There are several kinds of doctors who can treat this infection. First, you can go to a primary care physician such as a family doctor or an internist. If these are not available, consider urgent care or the emergency room. An infection of the eye is a serious enough illness to warrant immediate care.

Last, if you have an eye doctor such as an ophthalmologist, they also can treat your pingueculitis.

The eyes are very near the brain, so an infection that spreads may become very serious. In addition, the tissues of the eye are very delicate, so an infection may mean permanent damage to your vision. Any infection of the eye is a very serious matter. Getting immediate medical care may save your vision from permanent damage.

The treatments for this disease are not painful or complicated, so there is no reason not to get help as soon as possible.

 

New Research, New Possibilities

Because pingueculitis is a common disorder among people who are outdoors often, there have been recent studies looking closer at how to identify, prevent, and treat this disorder.

The following studies have shed more light on this illness:

» A study looking at the use of dipyridamole to prevent pinguecula.(7) This may be helpful for people who have had them surgically removed and then grow back.

» Research on argon laser photoablation to remove pinguecula.(8) This treatment approach is faster, safer, and requires less pain management.

 

Conclusion

Pingueculitis is an infection of the eye that can have a variety of unpleasant effects if left untreated. However, a full recovery is almost always possible with the right action and medications.

In addition, there are ways to prevent this illness or keep it from progressing.

If you notice that you are developing the telltale redness and pain in the eye that come with this disease, simply follow these easy steps:

» Call your doctor or ophthalmologist.

» Accurately report symptoms such as dry eye and/or fever that may be present.

» Take your antibiotic as prescribed.

» Use lubricating drops to keep your eyes moist.

» Avoid unprotected exposure to the wind, sunshine, dust, and other irritants to prevent worsening of your eye condition.

Talk to your doctor about surgery if the inflammation recurs or is very severe.


References

(1)https://medlineplus.gov/ency/article/001025.htm
(2)http://www.nytimes.com/health/guides/disease/pinguecula/overview.html
(3)https://www.uptodate.com/contents/eye-disorders-associated-with-chronic-kidney-disease?source=search_result&search=pinguecula&selectedTitle=2~6
(4)http://www.aafp.org/afp/2007/0915/p857.html
(5)http://healthncare.info/pinguecula-symptoms-causes-treatment-and-removal/
(6)https://www.aao.org/eye-health/diseases/pinguecula-pterygium
(7)https://www.sciencedaily.com/releases/2016/03/160315121104.htm
(8)https://www.deepdyve.com/lp/wiley/case-of-argon-laser-photoablation-of-pinguecula-elFkpXE8eN