Pterygium: What Is That Growth on the White of My Eye?

A growth on the white of your eye is most often a pinguecula (a small yellowish bump that stays on the white) or a pterygium (a wedge of pink, fleshy tissue that creeps onto the clear front of the eye). Both are non-cancerous and strongly linked to sun exposure, and most can be managed without surgery. Still, any growth that changes quickly or looks unusual should be checked soon.

Patients often point to the corner of their eye and ask, a little nervously, "What is this thing?" It's a fair question. Let me walk you through what I'm looking for when I see one.

What is the difference between a pterygium and a pinguecula?

Think of them as cousins.

A pinguecula (say "pin-GWEK-yoo-la") is a raised yellow or whitish patch on the white of the eye, usually right next to the colored part. It's made of changed protein and fat in the eye's surface layer. The key point: it stays on the white. It does not grow onto the cornea, the clear dome over your pupil and iris.

A pterygium (say "teh-RIJ-ee-um") is a triangle of tissue with tiny blood vessels running through it. It usually starts on the nose side and points toward the center of the eye. Unlike a pinguecula, a pterygium crosses onto the cornea. Some stay small for years. Others slowly advance.

You can have one in one eye or both. A pinguecula can sometimes be the starting point for a pterygium, which is one reason we keep an eye on both.

What causes these growths?

Ultraviolet (UV) light is the main culprit. Wind, dust, dry air and constant glare add to the irritation. That's why a pterygium is sometimes called "surfer's eye," even though most of my patients have never touched a surfboard.

Here in Georgia and East Tennessee, the sun does plenty of damage without an ocean nearby. I think about it with patients who:

• Work outdoors in construction, landscaping or farming
• Spend weekends boating on Lake Lanier, Allatoona or Boone Lake
• Play golf, tennis or softball
• Mow, garden or do lawn work without sunglasses
• Fish, hunt or hike in the mountains

Light bouncing off water, sand, concrete and even a bright lawn hits the eye from the side. The nose side of the eye catches a lot of that reflected light, which helps explain where these growths tend to show up.

What symptoms do they cause?

Often, none. Many people only notice the spot in the mirror or hear about it from family.

When symptoms do show up, they can include:

• Redness, especially after a day outside
• A gritty or "something in my eye" feeling
• Burning, itching or dryness
• A spot that looks bigger or redder when the eye is irritated
• Feeling self-conscious about how it looks

A pterygium can do one more thing. As it grows onto the cornea, it can pull on the surface and change its shape. That creates astigmatism, an uneven curve that makes vision blurry or stretched. If it reaches the center of the cornea, it can block vision directly. That's why we measure it over time instead of just glancing at it.

How are they treated without surgery?

Most pingueculae and many pterygia never need an operation. The goals are to calm the eye, protect it and watch it.

Protect from the sun. This is the most important step. Wear sunglasses that block 100% of UVA and UVB, and choose a wraparound or larger frame that covers the sides. Add a wide-brimmed hat when you're outside. Good sunglasses don't have to be boring, either. Browse our luxury and designer eyewear, and ask about prescription sun lenses so you aren't trading clear vision for protection.

Lubricate. Preservative-free artificial tears can soothe the gritty feeling and help on windy or dry days. If your eyes feel dry much of the time, our post on why eye drops stop working is worth a read.

Calm flare-ups. When a pterygium or pinguecula gets red and swollen, your eye doctor may prescribe a short course of anti-inflammatory drops. Some of these are steroids, which need a doctor's guidance because they can raise eye pressure. Please don't use leftover drops from a past problem.

Monitor. We note how far a pterygium extends onto the cornea and check your glasses prescription. Comparing these visit to visit tells us whether it's stable or growing.

When is removal considered?

Removal may be discussed when a pterygium:

• Is affecting your vision or causing astigmatism that glasses can't fully correct
• Is growing toward the center of the cornea
• Stays red and inflamed despite treatment
• Bothers you a great deal cosmetically

Bolt Eye Group does not perform surgery. When removal makes sense, we refer you to a surgeon who does. Surgeons use techniques designed to lower the chance of regrowth, but a pterygium can come back. After surgery, sun protection matters more than ever. Your sunglasses and hat are part of the treatment plan, not an accessory.

When should you see an eye doctor?

Any new spot on the eye deserves one exam so you know what it is. Other growths on the eye's surface, including rare cancers and pigmented lesions, can look similar to a pterygium or pinguecula at first glance. Only an exam can sort them out.

Get it checked promptly if a spot on your eye:

• Changes size, shape or color quickly
• Bleeds or looks crusty
• Is brown, black or has an unusual color
• Looks bumpy, jelly-like or different from the other eye
• Comes with blurry vision that's getting worse
• Becomes painful, or the eye stays red for days

Call us right away or go to the emergency room if you have sudden vision loss or severe eye pain.

How we do it at Bolt Eye Group

At each of our five offices, a comprehensive exam includes a full eye-health check of the front and back of the eye. For $39, you also get photos of your retina and optic nerve and a map of your cornea. For a pterygium or pinguecula, we look closely under the microscope, note the size of the growth, and check whether it's affecting your prescription. If your eye is red and irritated, we can usually see you the same day, on the days each office is open.

Our in-office opticians can help you find sunglasses that fit well and cover the sides of the eye, including designer frames from Jacques Marie Mage, Lindberg, Mykita, Lunor and Gucci. We accept VSP, EyeMed, Davis Vision, Spectera, Medicare and major medical plans, including Blue Cross Blue Shield, Aetna, UnitedHealthcare, Cigna and Humana. HSA/FSA and CareCredit are welcome.

Frequently asked questions

Is a pterygium cancer?

No. A pterygium is a non-cancerous growth. However, some rare surface cancers can look similar, so any new or changing spot on the eye should be examined by an eye doctor.

Will a pinguecula turn into a pterygium?

Not usually, but it can happen. Both are driven by sun and irritation, so protecting your eyes from UV light helps with both. We'll compare your eye at each visit to watch for changes.

Can a pterygium go away on its own?

A pterygium doesn't typically shrink away. Lubricating drops, sun protection and, when needed, prescription drops can calm the redness. That often makes it less noticeable.

Do I need surgery?

Most people don't. Surgery is usually considered when a pterygium affects vision, grows toward the center of the eye, stays inflamed or is a major cosmetic concern. If it's needed, we refer you to a surgeon.

Can I wear contact lenses with a pterygium?

Sometimes. A raised growth can make lenses uncomfortable or cause them to sit poorly. Talk to your eye doctor, who can check the fit and suggest options.

Book an exam at your nearest Bolt Eye Group office

Noticed a spot on the white of your eye? Let's take a look. Book an exam at your nearest Bolt Eye Group office in Canton, East Cobb/Marietta, Lawrenceville, Riverdale or Johnson City, TN. See all locations and directions.