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Pinguecula

Posted: Mon Dec 09, 2013 3:08 pm
by a1mamacat
anyone have experience with these?

If so, is it worth the time and pain to have it removed, realizing it will probably grow back?

Re: Pinguecula

Posted: Mon Dec 09, 2013 6:25 pm
by Bob Juch
Nope, one of the few eye problems I haven't had yet. :(

Re: Pinguecula

Posted: Fri Dec 13, 2013 2:35 pm
by tanstaafl2
a1mamacat wrote:anyone have experience with these?

If so, is it worth the time and pain to have it removed, realizing it will probably grow back?
I have some passing experience with these although it has been awhile.

They are pain because as you note they do often grow back. It rarely needs to be removed unless it becomes sufficiently problematic and large that it is so irritated that you really want it removed or it extends onto the cornea becoming a pterygium. Removing it for "cosmetic" reasons is usually not worth it.

If it becomes a pterygium large enough to threaten vision then it may need to be removed and I found that rotating a graft flap of new conjunctiva down from the upper part of the eye reduces the chance of recurrence (not something everyone will routinely do, especially for the first occurence). But it can take a while for them to fully heal and the eye tends to be pretty irritated during that time.

Re: Pinguecula

Posted: Fri Dec 13, 2013 2:52 pm
by a1mamacat
tanstaafl2 wrote:
a1mamacat wrote:anyone have experience with these?

If so, is it worth the time and pain to have it removed, realizing it will probably grow back?
I have some passing experience with these although it has been awhile.

They are pain because as you note they do often grow back. It rarely needs to be removed unless it becomes sufficiently problematic and large that it is so irritated that you really want it removed or it extends onto the cornea becoming a pterygium. Removing it for "cosmetic" reasons is usually not worth it.

If it becomes a pterygium large enough to threaten vision then it may need to be removed and I found that rotating a graft flap of new conjunctiva down from the upper part of the eye reduces the chance of recurrence (not something everyone will routinely do, especially for the first occurence). But it can take a while for them to fully heal and the eye tends to be pretty irritated during that time.
Thanks Bruce. I knew you would have an answer. It is mostly just that 'grit in the eye' feeling that (pun intended) irritates me. It is off to the side, outer eye, and doesn't seem to have any effect on vision. Perhaps I will just wait until I have to have my cataract surgery dont in a few years, and kill two birds with one scalpel.

Re: Pinguecula

Posted: Fri Dec 13, 2013 3:09 pm
by Bob Juch
a1mamacat wrote:
tanstaafl2 wrote:
a1mamacat wrote:anyone have experience with these?

If so, is it worth the time and pain to have it removed, realizing it will probably grow back?
I have some passing experience with these although it has been awhile.

They are pain because as you note they do often grow back. It rarely needs to be removed unless it becomes sufficiently problematic and large that it is so irritated that you really want it removed or it extends onto the cornea becoming a pterygium. Removing it for "cosmetic" reasons is usually not worth it.

If it becomes a pterygium large enough to threaten vision then it may need to be removed and I found that rotating a graft flap of new conjunctiva down from the upper part of the eye reduces the chance of recurrence (not something everyone will routinely do, especially for the first occurence). But it can take a while for them to fully heal and the eye tends to be pretty irritated during that time.
Thanks Bruce. I knew you would have an answer. It is mostly just that 'grit in the eye' feeling that (pun intended) irritates me. It is off to the side, outer eye, and doesn't seem to have any effect on vision. Perhaps I will just wait until I have to have my cataract surgery dont in a few years, and kill two birds with one scalpel.
I wouldn't do that! Depending on where the pinguecula is, they may have no choice but to remove it because it's in the way, but that would have to be done first, otherwise you don't want to complicate things.

Re: Pinguecula

Posted: Fri Dec 13, 2013 3:19 pm
by a1mamacat
Bob Juch wrote:
a1mamacat wrote:
tanstaafl2 wrote:
I have some passing experience with these although it has been awhile.

They are pain because as you note they do often grow back. It rarely needs to be removed unless it becomes sufficiently problematic and large that it is so irritated that you really want it removed or it extends onto the cornea becoming a pterygium. Removing it for "cosmetic" reasons is usually not worth it.

If it becomes a pterygium large enough to threaten vision then it may need to be removed and I found that rotating a graft flap of new conjunctiva down from the upper part of the eye reduces the chance of recurrence (not something everyone will routinely do, especially for the first occurence). But it can take a while for them to fully heal and the eye tends to be pretty irritated during that time.
Thanks Bruce. I knew you would have an answer. It is mostly just that 'grit in the eye' feeling that (pun intended) irritates me. It is off to the side, outer eye, and doesn't seem to have any effect on vision. Perhaps I will just wait until I have to have my cataract surgery dont in a few years, and kill two birds with one scalpel.
I wouldn't do that! Depending on where the pinguecula is, they may have no choice but to remove it because it's in the way, but that would have to be done first, otherwise you don't want to complicate things.

Did I miss your graduation from medical school?

So Sorry

Congratulations Dr. Juch.

Re: Pinguecula

Posted: Fri Dec 13, 2013 3:22 pm
by Bob Juch
a1mamacat wrote:
Bob Juch wrote:
a1mamacat wrote:
Thanks Bruce. I knew you would have an answer. It is mostly just that 'grit in the eye' feeling that (pun intended) irritates me. It is off to the side, outer eye, and doesn't seem to have any effect on vision. Perhaps I will just wait until I have to have my cataract surgery dont in a few years, and kill two birds with one scalpel.
I wouldn't do that! Depending on where the pinguecula is, they may have no choice but to remove it because it's in the way, but that would have to be done first, otherwise you don't want to complicate things.

Did I miss your graduation from medical school?

So Sorry

Congratulations Dr. Juch.
I've had cataracts and four subsequent operations on my eyes. I know what I'm talking about --- unfortunately.

Re: Pinguecula

Posted: Mon Dec 16, 2013 3:54 pm
by tanstaafl2
If in fact the pinguecula is really that inflamed it might be best to do them separately from one another. That said, with the current technology it would not be particularly difficult to do both in one sitting if the pinguecula is not significantly irritated. Of course if it is not significantly irritated then does it really need to be removed? Perhaps if the irritation is periodic and you can catch it in a quiet phase I suppose.

A pterygium would be a different story. You would generally not want to do that in the same setting as cataract surgery. But a pinguecula doesn't necessarily always become a pterygium. If yours is frequently irritated it may be more likely to develop into a pterygium (usually has a more triangular shape whereas a pinguecula is usually more of a rounded blob!).

Re: Pinguecula

Posted: Mon Dec 16, 2013 4:01 pm
by a1mamacat
tanstaafl2 wrote:If in fact the pinguecula is really that inflamed it might be best to do them separately from one another. That said, with the current technology it would not be particularly difficult to do both in one sitting if the pinguecula is not significantly irritated. Of course if it is not significantly irritated then does it really need to be removed? Perhaps if the irritation is periodic and you can catch it in a quiet phase I suppose.

A pterygium would be a different story. You would generally not want to do that in the same setting as cataract surgery. But a pinguecula doesn't necessarily always become a pterygium. If yours is frequently irritated it may be more likely to develop into a pterygium (usually has a more triangular shape whereas a pinguecula is usually more of a rounded blob!).

Well if asked to describe it, I would liken it to a small round pimple on the eyeball, seemingly the same colour as the conjunctiva, about the size of the head of a straight pin. (delightful visual ain't it?) I have to have my annual vision check up next month anyway, and I am sure the opthalmologist will have something to say about it. I was just making sure I didn't need to rush in panicing :roll:

Re: Pinguecula

Posted: Mon Dec 16, 2013 4:30 pm
by tanstaafl2
a1mamacat wrote:
tanstaafl2 wrote:If in fact the pinguecula is really that inflamed it might be best to do them separately from one another. That said, with the current technology it would not be particularly difficult to do both in one sitting if the pinguecula is not significantly irritated. Of course if it is not significantly irritated then does it really need to be removed? Perhaps if the irritation is periodic and you can catch it in a quiet phase I suppose.

A pterygium would be a different story. You would generally not want to do that in the same setting as cataract surgery. But a pinguecula doesn't necessarily always become a pterygium. If yours is frequently irritated it may be more likely to develop into a pterygium (usually has a more triangular shape whereas a pinguecula is usually more of a rounded blob!).

Well if asked to describe it, I would liken it to a small round pimple on the eyeball, seemingly the same colour as the conjunctiva, about the size of the head of a straight pin. (delightful visual ain't it?) I have to have my annual vision check up next month anyway, and I am sure the opthalmologist will have something to say about it. I was just making sure I didn't need to rush in panicing :roll:
Certainly sounds like a pinguecula! I've got some toenail clippers handy and could fix you right up! Don't worry, I haven't used 'em in a while and most of the toe jam has dried...

Re: Pinguecula

Posted: Mon Dec 16, 2013 6:18 pm
by a1mamacat
tanstaafl2 wrote:
a1mamacat wrote:
tanstaafl2 wrote:If in fact the pinguecula is really that inflamed it might be best to do them separately from one another. That said, with the current technology it would not be particularly difficult to do both in one sitting if the pinguecula is not significantly irritated. Of course if it is not significantly irritated then does it really need to be removed? Perhaps if the irritation is periodic and you can catch it in a quiet phase I suppose.

A pterygium would be a different story. You would generally not want to do that in the same setting as cataract surgery. But a pinguecula doesn't necessarily always become a pterygium. If yours is frequently irritated it may be more likely to develop into a pterygium (usually has a more triangular shape whereas a pinguecula is usually more of a rounded blob!).

Well if asked to describe it, I would liken it to a small round pimple on the eyeball, seemingly the same colour as the conjunctiva, about the size of the head of a straight pin. (delightful visual ain't it?) I have to have my annual vision check up next month anyway, and I am sure the opthalmologist will have something to say about it. I was just making sure I didn't need to rush in panicing :roll:
Certainly sounds like a pinguecula! I've got some toenail clippers handy and could fix you right up! Don't worry, I haven't used 'em in a while and most of the toe jam has dried...

Shudder.....