PURPOSE: To assess the relationship between baseline pterygium and pinguecula and the five-year incidence of age-related maculopathy (ARM). DESIGN: Popula tion-based longitudinal study. METHODS: The Blue Mountains Eye Study examined 3654 residents aged 49+years during 1992 to 1994 and then re-examined 2335 (7 5.1%of survivors) after five years. Retinal photographs were graded using the W isconsin Age-Related Maculopathy Grading System. Slit-lamp examination recorde d pterygium and pinguecula. Eye-specific data were analyzed using generalized e stimating equation models. RESULTS: After adjusting for age, gender, and smoking , eyes with pterygium or previous pterygium surgery had a higher risk of inciden t late ARM, odds ratio (OR) 3.3, 95%confidence interval (CI) 1.1 to 10.3, early ARM (OR 1.8, CI 1.1 to 2.9) and soft drusen (OR 2.0, CI 1.9 to 3.4), than eyes without pterygium. We found no association between pinguecula and incident ARM. CONCLUSIONS: This study found that pterygium was associated with a two-to three fold increased risk of incident late and early ARM. METHODS: The Blue Mountains Eye Study examined 3654 persons aged 49 + years during Retinal photographs were graded using the W isconsin Age-Related Maculopathy Grading System. Slit-lamp examination recorde d pterygium and pinguecula. Eye-specific data were analyzed using generalized e stimating equation models. RESULTS: After adjusting for age, gender, and smoking, eyes with pterygium or previous pterygium surgery had a higher risk of inciden t late ARM, odds ratio (OR) 3.3, 95% confidence interval ) 1.1 to 10.3, early ARM (OR 1.8, CI 1.1 to 2.9) and soft drusen (OR 2.0, CI 1.9 to 3.4), than eyes without pterygium. We found no association between pinguecula and incident ARM. CONCLUSIONS: This study found that pterygium was associated with a two-to three fold increased risk of incident late and early ARM.