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Conjunctival anatomy
Anatomy & Optics
Key Points
- •The conjunctiva has 3 regions: palpebral (firmly adherent to tarsal plate), forniceal (loosely attached, highest goblet cells + Krause glands + CALT), and bulbar (loose over sclera, firmly attached at limbus); total surface area ~17 cm2
- •Goblet cells produce MUC5AC mucin (gel-forming, essential for tear film stability); highest density at inferonasal fornix; loss → dry eye, xerosis; absent in LSCD; presence on cornea → conjunctivalisation
- •Papillae (central vascular core, fibrous septae) form on tarsal conjunctiva; follicles (avascular, lymphoid centre) form in fornices/loose conjunctiva; follicles do NOT form in neonates <3 months (adenoid layer not yet developed)
- •The plica semilunaris is the vestigial third eyelid at the medial canthus; the caruncle is a transitional skin-conjunctiva structure with sebaceous glands, fine hairs, and accessory lacrimal tissue - can give rise to papillomas, oncocytomas, melanomas
- •Conjunctival autograft after pterygium excision reduces recurrence to ~5% (vs 40-50% with bare sclera technique); impression cytology is the key investigation for goblet cell density, squamous metaplasia, and LSCD detection
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13 more sections are included with the Clinical plan.
- Definition
- Epidemiology
- Aetiology and causes
- Pathogenesis
- Classification
- Clinical features