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Pinguecula is a yellowish, elevated conjunctival nodule in the area of the palpebral fissure. It is common in persons over age 35 years. Pterygium is a fleshy, triangular encroachment of the conjunctiva onto the cornea and is usually associated with prolonged exposure to wind, sun, sand, and dust (eFigure 7–22). Pinguecula and pterygium are often bilateral and occur more frequently on the nasal side of the conjunctiva.

eFigure 7–22.

Pterygium extending across the cornea.

Pingueculae rarely grow but may become inflamed (pingueculitis). Pterygia become inflamed and may grow. Treatment is rarely required for inflammation of pinguecula or pterygium, and artificial tears are often beneficial.

The indications for excision of pterygium are growth that threatens vision by encroaching on the visual axis, marked induced astigmatism, or severe ocular irritation.

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Shahraki  T  et al. Pterygium: an update on pathophysiology, clinical features, and management. Ther Adv Ophthalmol. 2021;13:25158414211020152.
[PubMed: 34104871]  

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