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In vivo confocal microscopy of the bulbar conjunctiva
Article first published online: 11 MAY 2009
DOI: 10.1111/j.1442-9071.2009.02065.x
© 2009 The Authors. Journal compilation © 2009 Royal Australian and New Zealand College of Ophthalmologists
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How to Cite
Efron, N., Al-Dossari, M. and Pritchard, N. (2009), In vivo confocal microscopy of the bulbar conjunctiva. Clinical & Experimental Ophthalmology, 37: 335–344. doi: 10.1111/j.1442-9071.2009.02065.x
Publication History
- Issue published online: 30 JUN 2009
- Article first published online: 11 MAY 2009
- Received 20 October 20008; accepted 2 April 2009.
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Keywords:
- conjunctiva;
- goblet cell density;
- Langerhans cell density;
- laser scanning confocal microscopy
Abstract
Background: The aim of this work is to develop a more complete qualitative and quantitative understanding of the in vivo histology of the human bulbar conjunctiva.
Methods: Laser scanning confocal microscopy (LSCM) was used to observe and measure morphological characteristics of the bulbar conjunctiva of 11 healthy human volunteer subjects.
Results: The superficial epithelial layer of the bulbar conjunctiva is seen as a mass of small cell nuclei. Cell borders are sometimes visible. The light grey borders of basal epithelial cells are clearly visible, but nuclei can not be seen. The conjunctival stroma is comprised of a dense meshwork of white fibres, through which traverse blood vessels containing cellular elements. Orifices at the epithelial surface may represent goblet cells that have opened and expelled their contents. Goblet cells are also observed in the deeper epithelial layers, as well as conjunctival microcysts and mature forms of Langerhans cells. The bulbar conjunctiva has a mean thickness of 32.9 ± 1.1 µm, and a superficial and basal epithelial cell density of 2212 ± 782 and 2368 ± 741 cells/mm2, respectively. Overall goblet and mature Langerhans cell densities are 111 ± 58 and 23 ± 25 cells/mm2, respectively.
Conclusions: LSCM is a powerful technique for studying the human bulbar conjunctiva in vivo and quantifying key aspects of cell morphology. The observations presented here may serve as a useful marker against which changes in conjunctival morphology due to disease, surgery, drug therapy or contact lens wear can be assessed.