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Ophthalmic Plastic and Reconstructive...A 57-year-old Black man presented with the recent onset of a pigmented temporal epibulbar lesion. As pigmentation of conjunctival epithelial lesions is correlated with...
A 57-year-old Black man presented with the recent onset of a pigmented temporal epibulbar lesion. As pigmentation of conjunctival epithelial lesions is correlated with complexion pigmentation, the lesion was presumed to represent a pigmented ocular surface squamous neoplasia (OSSN). Excisional biopsy, however, revealed a pigmented conjunctival seborrheic keratosis, a rare occurrence. The lesion lacked cytologic atypia. Intralesional processes of dendritic melanocytes were demonstrated by hematoxylin-eosin and Melan-A stains. Melanophages also contributed to clinical pigmentation. Subepithelial lymphocytic infiltration, elevated Ki67 proliferative rate, prominent mitotic activity, and subtle spongiosis afforded evidence of inflammation rather than malignancy in a lesion devoid of cytologic atypia.
Topics: Male; Humans; Middle Aged; Keratosis, Seborrheic; Conjunctiva; Conjunctival Neoplasms; Inflammation
PubMed: 36806147
DOI: 10.1097/IOP.0000000000002346 -
Contact Lens & Anterior Eye : the... Aug 2020In vivo confocal microscopy (IVCM) has been used for over 10 years to assess the goblet cell density (GCD) within the human conjunctiva, but the reported values have... (Review)
Review
BACKGROUND
In vivo confocal microscopy (IVCM) has been used for over 10 years to assess the goblet cell density (GCD) within the human conjunctiva, but the reported values have been variable with no obvious indications as to why.
METHODS
From publications between 2008 and 2019, representative GCD values were extracted, as well as on the image sampling strategy used.
RESULTS
Average GCD values for any particular group of individuals ranged from 7 to 979 goblet cells / sq. mm, and with one notable outlier removed, an overall group-mean value for GCD (+/- SD) from single site locations was 207 +/- 143 goblet cells / sq. mm from 15 data sets for those usually designated as control subjects, with a value of 190 +/- 161 goblet cells / sq. mm calculated from 20 single site data sets from other (patient) groups. An overall analysis indicated that the reported average values for GCD from different groups of individuals increased according to the number of images assessed / individual (Spearman rho = 0.304), on the number of individuals evaluated to generate an averaged value for each group (rho = 0.367), and the total number of images assessed (rho = 0.346, multivariate analysis partial r = greater or = to 0.522).
CONCLUSIONS
In the use of confocal microscopy to assess the number of goblet cells in the human bulbar conjunctiva, the substantial differences reported appear to be linked to the protocols used for image selection, and some type of standardization needs to be developed.
Topics: Cell Count; Conjunctiva; Goblet Cells; Humans; Intravital Microscopy; Microscopy, Confocal
PubMed: 31954627
DOI: 10.1016/j.clae.2020.01.004 -
Cornea Sep 2023The aim of this study was to describe a novel presentation of conjunctival smooth muscle hamartoma and review the histopathologic findings of this entity. (Review)
Review
PURPOSE
The aim of this study was to describe a novel presentation of conjunctival smooth muscle hamartoma and review the histopathologic findings of this entity.
METHODS
A 17-year-old African American adolescent boy presented with a pink, nontender lesion of the right bulbar conjunctiva that did not improve with medical management. He had no previous medical or ocular history. The lesion was excised.
RESULTS
Histopathologic examination disclosed morphologically benign smooth muscle bundles within the substantia propria that stained positively for smooth muscle actin, vimentin, and desmin consistent with the diagnosis of a smooth muscle hamartoma.
CONCLUSIONS
Although congenital smooth muscle hamartomas of the conjunctiva have been rarely reported in the literature, this is the first described case of a smooth muscle hamartoma presenting in adolescence in the bulbar conjunctiva. This lesion should be considered in the differential diagnosis for adolescents with similar appearing lesions.
Topics: Male; Humans; Adolescent; Hamartoma; Muscle, Smooth; Muscular Diseases; Skin Diseases; Conjunctiva; Diagnosis, Differential
PubMed: 37267468
DOI: 10.1097/ICO.0000000000003314 -
Disease Markers 2022Bulbar conjunctival microcirculation is a microvascular system distributed in the translucent bulbar conjunctiva near the corneal limbus. Multiple ocular diseases lead... (Review)
Review
Bulbar conjunctival microcirculation is a microvascular system distributed in the translucent bulbar conjunctiva near the corneal limbus. Multiple ocular diseases lead to bulbar conjunctival microcirculation alterations, which means that bulbar conjunctival microcirculation alterations would be potential screening and diagnostic indicators for these ocular diseases. In recent years, with the emergence and application of a variety of noninvasive observation devices for bulbar conjunctiva microcirculation and new image processing technologies, studies that explored the potential of bulbar conjunctival microcirculation alterations in the diagnosis of ocular diseases have been emerging. However, the potential of bulbar conjunctival microcirculation alterations as indicators for ocular diseases has not been exploited to full advantage. The observation devices, image processing methods, and algorithms are not unified. And large-scale research is needed to concrete bulbar conjunctival microcirculation alterations as indicators for ocular diseases. In this paper, we provide an update on the progress of bulbar conjunctival microcirculation alterations in the diagnosis of ocular diseases in recent five years (from January 2017 to March 2022). Relevant ocular diseases include contact lens wearing, dry eye, conjunctival malignant melanoma, conjunctival nevus, and diabetic retinopathy.
Topics: Conjunctiva; Humans; Microcirculation
PubMed: 36072898
DOI: 10.1155/2022/4046809 -
Plastic and Reconstructive Surgery Jan 2024Bulbar conjunctival prolapse is one of the complications of conjoint fascial sheath (CFS) suspension and has a negative impact on surgical results. To explore the...
BACKGROUND
Bulbar conjunctival prolapse is one of the complications of conjoint fascial sheath (CFS) suspension and has a negative impact on surgical results. To explore the prevention methods of this complication, the authors compared the incidence of it between the below-conjunctiva fornix-bulbar conjunctiva-Tenon capsule (CBT) approach and the above-CBT approach to dissecting CFS in CFS suspension and shared their experience in the treatment of bulbar conjunctival prolapse.
METHODS
From January of 2020 to August of 2021, 81 patients with severe congenital ptosis who underwent CFS suspension were enrolled and divided into two groups. Forty-five patients' (group A) CFS was dissected by means of the below-CBT approach and 36 patients' (group B) CFS was dissected by means of the above-CBT approach. Data regarding the incidence and outcomes of bulbar conjunctival prolapse and the postoperative condition were collected and analyzed.
RESULTS
The incidence of bulbar conjunctival prolapse was 24.44% in group A and 2.78% in group B. Of the 12 bulbar conjunctival prolapse patients, seven patients' conditions improved after conservative treatment, and five did not. All of them underwent bulbar conjunctiva resection within 1 year and were cured. No recurrent prolapse was observed within 3 months postoperatively. At the last follow-up, the mean marginal reflex distance 1 and palpebral fissure height were 4.09 ± 0.19 mm and 9.85 ± 0.62 mm, respectively. There were no complications except lagophthalmos (16 eyelids), asymmetric eyelid contour (one patient), and trichiasis (two eyelids).
CONCLUSIONS
The incidence of bulbar conjunctival prolapse decreased significantly by dissecting CFS by means of the above-CBT approach. For patients with bulbar conjunctival prolapse after CFS suspension, bulbar conjunctiva resection could provide satisfactory results.
CLINICAL QUESTION/LEVEL OF EVIDENCE
Therapeutic, IV.
Topics: Humans; Tenon Capsule; Conjunctiva; Eyelids; Blepharoptosis; Prolapse
PubMed: 36988680
DOI: 10.1097/PRS.0000000000010467 -
The Ocular Surface Jul 2012Goblet cells of the conjunctiva are the main source of mucus for the ocular surface. The objectives of this review are to consider the goblet cells as assessed by... (Review)
Review
Goblet cells of the conjunctiva are the main source of mucus for the ocular surface. The objectives of this review are to consider the goblet cells as assessed by various histological, cytological and electron microscopy methods, and to assess the consistency of published reports (over more than 25 years) of goblet cell density (GCD) from impression cytology specimens from nominally healthy human subjects. Reported GCD values have been notably variable, with a range from 24 to 2226 cells/mm² for average values. Data analysis suggests that a high density of goblet cells should be expected for the healthy human conjunctiva, with a tendency toward higher values in samples taken from normally covered locations (inferior and superior bulbar conjunctiva) of the open eye (at 973 +/- 789 cells/ mm²) than in samples taken from exposed (interpalpebral) locations (at 427 +/- 376 cells/mm²). No obvious change in GCD was found with respect to age, perhaps because the variability of the data did not allow detection of any age-related decline in GCD. Analyses of published data from 33 other sources indicated a trend for GCD to be lower than normal across a spectrum of ocular surface diseases.
Topics: Cell Count; Conjunctiva; Cytological Techniques; Goblet Cells; Humans; Mucus
PubMed: 22814643
DOI: 10.1016/j.jtos.2012.05.001 -
Vestnik Oftalmologii 2016The article presents a literature review of the latest achievements in visualizing microcirculation and studying anatomical and physiological characteristics of... (Review)
Review
The article presents a literature review of the latest achievements in visualizing microcirculation and studying anatomical and physiological characteristics of microcirculation in the bulbar conjunctiva in various diseases.
Topics: Conjunctiva; Eye Diseases; Humans; Microcirculation; Regional Blood Flow
PubMed: 27347572
DOI: 10.17116/oftalma2016132290-95 -
The Ocular Surface Jan 2022
Topics: Conjunctiva; Humans; Keratoconjunctivitis; Protein Serine-Threonine Kinases; Steroids
PubMed: 34883275
DOI: 10.1016/j.jtos.2021.12.002 -
The Journal of Craniofacial Surgery May 2021A 52-year-old woman presented with persistent eye irritation following her third transconjunctival ptosis surgery. Examination revealed a yellow-pink nodular lesion in...
A 52-year-old woman presented with persistent eye irritation following her third transconjunctival ptosis surgery. Examination revealed a yellow-pink nodular lesion in the bulbar conjunctiva. Excision biopsy and histopathology showed granulation tissue. However, the tumor recurred 1 month postoperatively. Repeat biopsy and histopathology revealed amyloid deposits. Systemic work-up showed no other lesion. A retained suture found in the upper fornix was also removed. No tumor recurrence has since been noted over the 7-month follow-up period. This report aims to highlight a case of bulbar conjunctival amyloidosis that developed as a complication following multiple transconjunctival eyelid surgeries.
Topics: Amyloidosis; Biopsy; Conjunctiva; Conjunctival Diseases; Female; Humans; Middle Aged; Recurrence
PubMed: 33027178
DOI: 10.1097/SCS.0000000000007159 -
The Ocular Surface Oct 2015Nucleus-to-cytoplasm (N:C) characteristics of published images of human bulbar conjunctival cells designated as showing severe (grade 3) squamous metaplasia were... (Review)
Review
Nucleus-to-cytoplasm (N:C) characteristics of published images of human bulbar conjunctival cells designated as showing severe (grade 3) squamous metaplasia were retrospectively assessed. From publications over a 40-year period, measurements were made from images of cell and nucleus size (based on areas and dimensions) and four different calculations were made for nucleo-cytoplasmic (N:C) ratios. From 54 published images, the mean nucleus-to-cytoplasm area ratio (NU/CYT AREA ratio) was 0.145 +/- 0.077 (range 0.052 to 0.346), compared to two different reference set values of 0.069 +/- 0.017 and 0.080 +/- 0.021. Similarly, a nucleus-to-cytoplasm length ratio (as LNLONG) was 0.308 +/- 0.080 (range 0.191 to 0.475) compared to reference values of 0.226 +/- 0.032 and 0.236 +/- 0.034. Similar differences in reference values were obtained using two other N:C ratio calculations. A wide range of values was found for morphometric N:C indices from published images, especially those without a scale bar, indicating a high incidence of inconsistent grading assignments. Overall, only about 30% of the published images showed morphological features consistent with severe squamous metaplasia (i.e., with the rest neither enlarged nor showing substantially changed N:C ratios) with no substantial pictorial evidence indicating that cells from the human bulbar conjunctiva have pyknotic nuclei. Current evidence indicates that grade 3 squamous metaplasia cells should be substantially enlarged.
Topics: Cell Nucleus; Cell Nucleus Size; Conjunctiva; Conjunctival Neoplasms; Cytological Techniques; Humans; Metaplasia; Neoplasm Staging
PubMed: 26164095
DOI: 10.1016/j.jtos.2015.05.003