What is the Growth on my Eye? Risks of Not Removing the New Growth. Risk of not removing Pinguecula or Ptergyium.

The majority of growths on an eyeball are due to sun exposure. Other rare causes involve genetic mutations causing a cancer.

Here are the most common diagnosis for a New Growth on the Surface of the Eye:
1. Pinguecula
2. Pterygium
3. Nevus: this is a mole on the surface of the eye. These are most often benign. Rarely a Primary Acquired Melanosis (PAM) can develop into a cancer so these need to be followed over time.
4. Conjunctivochalasis: this is not a new growth, but just a laxity of the conjunctiva. But it can sometimes look like a new growth and it is a very common condition.
5. Pre-cancer: this is rare. Can develop from PAM.
6. Cancer: this is also thankfully rare. There are many types of cancerous growth that can occur on the eyeball. The most common is:
a. Squamous Carcinoma
b. Malignant Melanoma
c. Lymphoma
7. Foreign body that was missed: this is rare but I’ve seen many in my career.

Thankfully 5-7 are not common.

This growth if it has grown onto the cornea (the clear window of your eye) is called a PTERYGIUM which is a new growth of blood vessels and scar tissue.

If it has not grown onto the cornea it is called a Pinguecula. They are both mostly due to chronic sun exposure over a lifetime. They can be made worse by smoking, dry eyes/dry environments, poor diet, genetic risks.

Treatment initially includes: always wear sunglasses; use lid hygiene to help (see below); use cold non-preserved artificial tears to help temporarily with redness; an MD can Rx Steroid drops if needed but this has risks of cataract & glaucoma if used for months; surgical excision is otherwise the best option if it is growing or bothering you.

Early removal of growth may be recommended in some patients to prevent chronic dry eye in future.


Pterygium Symptoms:

Most patients have no symptoms in the initial stages of a pterygium. After time, a patient or friend might notice a small piece of reddish tissue growing over the coloured part of the eye from the white of the eye. 

In some patients, this pterygium may become red and inflamed in certain circumstances: smoke-filled rooms, air-conditioning locations, lack of sleep, sunlight, contact lens use. 

In a small percentage of patients, the pterygium may actually interfere and reduce vision by pulling on the cornea (window of the eye) and deforming it (astigmatism), or may grow to the extent that it encroaches on the line of vision so as to interferes with vision. 

In an extremely small number of patients, the pterygium may actually prevent the eye from moving fully in all directions, particularly in the direction towards the ear. 

Most pterygiums are cosmetically annoying. For this reason, most pterygiums are removed before they grow significantly over the cornea. Early removal has been shown to decrease recurrence rates and decrease the risk of being left with a permanent white scar on the cornea. Additionally early removal decrease the size of the conjunctival autograft harvested from the patient’s superior (under lid area) conjunctiva which is used as a donor to patch the affected site and work as a blockade from future recurrence. 
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