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The British Journal of Ophthalmology Dec 1982Six cases of keratoconjunctivitis caused by self-inflicted injury are described. The diagnosis is suggested by the combination of the characteristic sharply delineated...
Six cases of keratoconjunctivitis caused by self-inflicted injury are described. The diagnosis is suggested by the combination of the characteristic sharply delineated lesions localised in the more accessible inferior and nasal quadrants of the bulbar conjunctiva and cornea, together with the unconcerned attitude of the patient and other psychological features. Secondary post-traumatic erosions, infections, and allergies may complicate the clinical appearances, and other functional eye disturbances including corneal anaesthesia may be detected. In all cases the eye condition resolved with a sympathetic but authoritative approach avoiding direct accusation. Avoidance of feelings about bereavement or sexual relationships were directly related to the onset of symptoms in 3 cases. In some patients the psychological mechanism seemed inaccessible and they continued to produce new self-inflicted diseases with considerable physical and psychological morbidity. These more intractable cases need psychiatric investigation but usually resist referral.
Topics: Adolescent; Adult; Aged; Conjunctiva; Female; Humans; Keratoconjunctivitis; Self Mutilation
PubMed: 7171528
DOI: 10.1136/bjo.66.12.781 -
Investigative Ophthalmology & Visual... Nov 2018Mucins, which play important roles on the ocular surface in wettability, lubrication, and barrier function, are classified into two categories: secreted mucins and... (Review)
Review
Mucins, which play important roles on the ocular surface in wettability, lubrication, and barrier function, are classified into two categories: secreted mucins and membrane-associated mucins. The most important secreted mucin on the ocular surface is MUC5AC, which is secreted by the conjunctival goblet cells. In the human conjunctiva, goblet cells are present in higher concentrations in the fornix, inferior nasal bulbar, and the lid wiper on the lid margin. The number of conjunctival goblet cells and MUC5AC expression/secretion are decreased in a patient with dry eye. In Japan, drugs that stimulate mucin secretion or increase the number of conjunctival goblet cells are commercially available. A P2Y2 receptor, diquafosol, stimulates tear fluid secretion from conjunctival epithelial cells and promotes mucin secretion from conjunctival goblet cells. Rebamipide was marketed originally as an oral therapeutic drug to treat gastritis in Japan. Topical rebamipide increases numbers of goblet cells in the bulbar conjunctiva and the lid wiper area of palpebral conjunctiva. Many researchers have reported decreases in the ocular surface mucin expression including MUC5AC secreted by goblet cells in patients with dry eye. However, it is unknown whether changes in mucin expression on the ocular surface cause or result from dry eye. Further study is needed to determine the true mechanism of dry eye disease.
Topics: Alanine; Conjunctiva; Dry Eye Syndromes; Goblet Cells; Humans; Mucin 5AC; Ophthalmic Solutions; Polyphosphates; Quinolones; Uracil Nucleotides
PubMed: 30481820
DOI: 10.1167/iovs.17-23623 -
Cornea Jan 2010The aim of this study was to investigate the capabilities of laser scanning confocal microscopy (LSCM) for undertaking qualitative and quantitative investigations of the...
PURPOSE
The aim of this study was to investigate the capabilities of laser scanning confocal microscopy (LSCM) for undertaking qualitative and quantitative investigations of the response of the bulbar conjunctiva to contact lens wear.
METHODS
LSCM was used to observe and measure morphological characteristics of the bulbar conjunctiva of 11 asymptomatic soft contact lens wearers and 11 healthy volunteer subjects (controls).
RESULTS
The appearance of the bulbar conjunctiva is consistent with known histology of this tissue based on light and electron microscopy. The thickness of the bulbar conjunctival epithelium of lens wearers (30.9 +/- 1.1 microm) was less than that of controls (32.9 +/- 1.1 microm) (P < 0.0001). Superficial and basal bulbar conjunctival epithelial cell densities in contact lens wearers were 91% and 79% higher, respectively, than that in controls (P < 0.0001). No difference was observed in goblet and Langerhans cell density between lens wearers and controls. Conjunctival microcysts were observed in greater numbers, and were larger in size, in lens wearers compared with controls.
CONCLUSIONS
The effects of contact lens wear on the human bulbar conjunctiva can be investigated effectively at a cellular level using LSCM. The observations in this study suggest that contact lens wear can induce changes in the bulbar conjunctiva such as epithelial thinning and accelerated formation and enlargement of microcysts, increased epithelial cell density, but has no impact on goblet or Langerhans cell density.
Topics: Adult; Cell Count; Conjunctiva; Conjunctival Diseases; Contact Lenses; Cysts; Epithelial Cells; Female; Goblet Cells; Humans; Langerhans Cells; Male; Microscopy, Confocal; Pilot Projects
PubMed: 19907292
DOI: 10.1097/ICO.0b013e3181acf82a -
[Zhonghua Yan Ke Za Zhi] Chinese... Feb 2019To explore the changes of microcirculation of the bulbar conjunctiva after wearing the contact lens and the relationship between contact lens discomfort and bulbar...
To explore the changes of microcirculation of the bulbar conjunctiva after wearing the contact lens and the relationship between contact lens discomfort and bulbar conjunctiva microcirculation. Prospective cohort study. The postgraduate students from School of Ophthalmology & Optometry and School of Biomedical Engineering of Wenzhou Medical University were included in this prospective cohort study. The subjects wore soft contact lenses, and the right eye was selected as the experimental eye. The ocular surface disease index (OSDI) questionnaire, Schirmer I and tear break-up time tests were completed before and after wearing the contact lens, and the conjunctival blood flow velocity and microvascular network density were also assessed by using functional slit lamp biomicroscopy. The changes of the indicators after wearing the contact lens were observed and the correlation between the subjective feelings of the wearers and the microcirculation parameters of the bulbar conjunctiva and the main factors affecting the subjective feelings of the wearers were analyzed. Twenty-seven subjects were enrolled in the study, including 8 males and 19 females, aged (22.7±1.6) years. The OSDI score was 11.860± 7.783 before wearing the contact lens and 24.017±12.181 after wearing the contact lens. The comparison before and after wearing the contact lens was statistically significant (-4.356, 0.001). The conjunctival blood flow velocity was (0.534±0.132) mm/s before wearing the contact lens and (0.587±0.134) mm/s after wearing the contact lens. The comparison was statistically significant before and after wearing the lens (-2.076, 0.048). OSDI was positively correlated with blood flow velocity at 1 month after wearing the contact lens (correlation coefficient 0.383, 0.048). The test results of the independent variables in the generalized estimating equation model showed that time and blood flow velocity were statistically significant (0.05). The blood flow velocity of the bulbar conjunctiva was increased after wearing the contact lens, and the contact lens discomfort of the wearers was positively correlated with the blood flow velocity of the bulbar conjunctiva. -.
Topics: Adult; Conjunctiva; Contact Lenses, Hydrophilic; Female; Humans; Male; Microcirculation; Microvessels; Prospective Studies; Young Adult
PubMed: 30772987
DOI: 10.3760/cma.j.issn.0412-4081.2019.02.006 -
Clinical & Experimental Ophthalmology May 2009The aim of this work is to develop a more complete qualitative and quantitative understanding of the in vivo histology of the human bulbar conjunctiva.
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 microm, and a superficial and basal epithelial cell density of 2212 +/- 782 and 2368 +/- 741 cells/mm(2), respectively. Overall goblet and mature Langerhans cell densities are 111 +/- 58 and 23 +/- 25 cells/mm(2), 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.
Topics: Adult; Cell Count; Conjunctiva; Female; Goblet Cells; Humans; Langerhans Cells; Male; Microscopy, Confocal
PubMed: 19594558
DOI: 10.1111/j.1442-9071.2009.02065.x -
Investigative Ophthalmology & Visual... Aug 2018To investigate the factors affecting microvascular responses in the bulbar conjunctiva of habitual contact lens (HCL) wearers.
PURPOSE
To investigate the factors affecting microvascular responses in the bulbar conjunctiva of habitual contact lens (HCL) wearers.
METHODS
A functional slit-lamp biomicroscope (FSLB) was used to image the temporal bulbar conjunctiva of habitual contact lens (HCL) wearers and non-contact lens (NCL) wearers. The vessel diameters and blood flow velocities (BFVs) were measured. Fractal analysis using Dbox as vessel density and D0 as vessel complexity were used to quantitatively analyze the microvascular network. One eye each of 91 NCL wearers and 75 HCL wearers was imaged.
RESULTS
The BFV of NCL wearers was 0.50 ± 0.14 mm/s, which was negatively correlated with age (r = -0.22, P < 0.05). The BFV, vessel diameter, Dbox, and D0 of HCL wearers was significantly higher than NCL wearers (P < 0.05). In these HCL wearers, BFVs were positively correlated with contact lens (CL) hours of wear per day and CL days of wear per week. BFV, Dbox, and D0 were not related to CL years of wear, CL power, CL base curve, and CL diameter (P > 0.05).
CONCLUSIONS
Vascular responses on the bulbar conjunctiva occurred in HCL wearers and appeared to be unrelated to sex or age, CL years of wear, and lens parameters, indicating that wearing a CL itself may be the predominant factor inducing these responses.
Topics: Adolescent; Adult; Aging; Conjunctiva; Contact Lenses; Female; Humans; Male; Microcirculation; Microvessels; Middle Aged; Slit Lamp; Young Adult
PubMed: 30098199
DOI: 10.1167/iovs.18-24216 -
The Journal of Veterinary Medical... Jan 2019An 8-year-old castrated Toy poodle presented with swelling and proptosis of the right third eyelid caused by an exophytic mass on the bulbar surface. Histologically, the...
An 8-year-old castrated Toy poodle presented with swelling and proptosis of the right third eyelid caused by an exophytic mass on the bulbar surface. Histologically, the mass was composed of stratified neoplastic basaloid cells, arranged in nests and interconnecting islands, which were mixed with tubular structures. Immunohistochemically, the basaloid cells were positive for p63 and cytokeratin (CK) 14, and the inner epithelial cells of the tubular structures were positive for CK7, CK8, and CK19. According to these findings, the mass was diagnosed as a basal cell adenocarcinoma. Although basal cell adenocarcinoma is rare in animals, it should be included in the list of differential diagnoses for superficial tumors of bulbar conjunctiva of third eyelid in dogs.
Topics: Adenocarcinoma; Animals; Conjunctiva; Conjunctival Neoplasms; Dog Diseases; Dogs; Female; Nictitating Membrane
PubMed: 30404994
DOI: 10.1292/jvms.18-0369 -
Archives of Ophthalmology (Chicago,... Oct 1963
Topics: Conjunctiva; Eye Neoplasms; Humans; Keratoacanthoma; Pathology
PubMed: 14078874
DOI: 10.1001/archopht.1963.00960050514014 -
International Ophthalmology Aug 2017To assess and compare the studies conducted in the literature with recurrence rates and the summary of the justified treatment approaches be presented. (Review)
Review
PURPOSE
To assess and compare the studies conducted in the literature with recurrence rates and the summary of the justified treatment approaches be presented.
METHOD
Pterygium, a fibrovascular tissue that proceeds from the bulbar conjunctiva towards the cornea, is quite a commonly seen ocular surface deterioration. The treatment is performed through a surgical excision, and the frequent recurrence of this disorder, despite the developments of today, is the major problem experienced in the wake of the surgery. There are various treatment methods applied for the prevention of recurrence; yet, there is no definite view as to what treatment is the most effective one. Since the recurrent pterygium cases are more aggressive than the primary pterygium, it is of great importance to determine the treatment method in which recurrence rate is the lowest. In different studies seen in the literature, there is difficulty in comparing the results due to the fact that the follow-up periods, recurrence criteria and the doses and durations of the medications administered differ from one another.
CONCLUSION
When the literature is reviewed, the bare sclera technique is not used due to the high rate of recurrence, whereas successful results can be achieved through the conjunctival autograft technique. Lower recurrence rates have been reported along with the administration of mitomycin C, 5-FU and other agents that were used as an adjuvant treatment.
Topics: Antineoplastic Agents; Combined Modality Therapy; Conjunctiva; Humans; Ophthalmologic Surgical Procedures; Pterygium; Recurrence; Transplantation, Autologous
PubMed: 27664148
DOI: 10.1007/s10792-016-0358-5 -
Vestnik Oftalmologii 1996
Review
Topics: Conjunctiva; Diabetes Complications; Diabetes Mellitus; Humans; Hypertension; Microcirculation; Retinal Vessels; Rheology
PubMed: 8659075
DOI: No ID Found