This is a small yellow-white growth that forms on the eye, starting from the white conjunctival skin, and spreading over the clear cornea. These are harmless growths and common in people with sun exposure or who work outside. The conjunctiva is a very thin layer of skin that covers the eye. This skin can become irritated by a lifetime of sun and wind exposure, causing the skin to thicken and grow a little bit … just like chronic irritation will cause the thickening of skin elsewhere on the body such as a callus on the hands or feet. When skin thickening happens on the eye, we call this a pterygium (or pinguecula if the spot is isolated on the conjunctiva only). Pterygium only occurs on the white of the eye at the three and nine o’clock positions because this is the part of the eye exposed to the elements (i.e., not covered by the eyelids). A pterygium can be aggravating as the eyelid rubs over it with every blink. When irritated, the pterygium can swell, turn red, and cause even more eye irritation. Early treatment usually involves lubrication with artificial tears and sunglasses. If this is not helping, allergy drops and even a mild steroid can be used to cool the eye down. Visine can be used as a short-term solution but should be used sparingly. If the pterygium persists, gets larger, or approaches the visual axis, than surgical excision can be considered. There are many techniques for removing a pterygium but the most definitive is a “conjunctival autograph.” This involves cutting the pterygium off and sewing/grafting another piece of conjunctival tissue (harvested from underneath the eyelid) in its place. This vastly decreases the chance that the pterygium will reform in the future and gives a good cosmetic result. This is done under topical anesthesia in the operating room.