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PubMed1998

Day to day variations in ocular surface staining of the bulbar conjunctiva.

PURPOSE: The purpose of this study was to characterize the variability of bulbar conjunctival staining over time in response to a single application of fluorescein. METHODS: Sixteen subjects were stained Monday through Friday for a 2-week period. Appointments were scheduled from 9:00 a.m. to 12:00 p.m. to minimize variance due to diurnal variation. Fluorescein stain was applied by touching a separate Ful-Glo strip wetted with nonpreserved saline to the lower palpebral conjunctiva of each eye, with the right eye being stained first. Immediately after application of the fluorescein, conjunctival staining was graded in a randomized order by two examiners, using cobalt blue illumination and a no. 15 Wratten enhancement filter. Conjunctival staining was assessed based upon a 0 to 4 grading scale with 0.5 grade increments. By evaluating the variability in staining over time for each subject, a representation of overall fluctuation for the group was obtained. RESULTS: The average duration for an episode of staining graded higher than the group median (grade 0.5) was found to be 2.0 +/- 2.4 days. Overall, a mean staining grade of 0.5 for the right eye and 0.6 for the left eye was found. Right and left eyes were found to correlate well (r = 0.67, p < 0.01, Spearman's correlation) and the mean difference was not statistically significant [p = 0.73, multi-way, repeated measures analysis of variance (ANOVA)]. The mean difference in grading between the two examiners was 0.1 grades (p = 0.67, multi-way, repeated measures ANOVA), with a correlation coefficient of r = 0.68 (p < 0.01, Spearman's correlation). CONCLUSIONS: Characterization of conjunctival staining over time may be useful in evaluating clinically suspect staining, and in determining its potential duration. The appearance and variability of the conjunctival staining patterns noted in this study indicate a potential relationship to normal physiological processes, such as desquamation. This study also demonstrated a low amount of variability between right and left eyes, supporting the use of contralateral studies in the assessment of conjunctival staining. It also demonstrated a good consistency between separate examiners despite not being standardized.

Adult↗
PubMed1993

Lateral canthal tendon resection with conjunctiva preservation for the treatment of lower eyelid laxity during lower eyelid blepharoplasty.

Lower eyelid laxity is a problem commonly encountered in patients undergoing lower eyelid blepharoplasty. Two problems associated with the numerous surgical procedures used for the management of this condition are (1) postoperative alteration of the shape of the palpebral fissure and lateral canthal angle and (2) difficulty with appropriate suture positioning or placement when reattaching the resected lateral canthal tendon. To address these problems, the surgical technique of lateral canthal tendon resection was modified by preserving the lateral conjunctiva, thus maintaining normal anatomic landmarks and ensuring proper suture placement. To date, this technique has been performed effectively on 50 patients who demonstrated mild to moderate eyelid laxity during preoperative evaluation for lower eyelid blepharoplasty. The only complication encountered has been undercorrection in one patient. The benefits of this procedure have been prevention of alteration of the palpebral fissure or canthal angle shape, greater ease and more accurate suture placement when reattaching the lateral canthal tendon, and avoidance of the need for full-thickness eyelid resection.

Aged↗
PubMed2001

Downward extension of the lacrimal gland under the bulbar conjunctiva after trabeculectomy.

PURPOSE: To describe two cases in which the lacrimal gland was considered to extend downward under the bulbar conjuctiva following trabeculectomy. PATIENTS AND METHODS: We report two patients who complained of epiphora after trabeculectomy. A biopsy was performed on the tissue under the bulbar conjunctiva on the periphery of the bleb of case 1. The anatomical relationship between the holes and the avascular filtering bleb in case 2 was investigated using ultrasound biomicroscopy. RESULTS: In case 1, a biopsy showed the lacrimal gland tissue filtrated with mononuclear cells. In case 2, ultrasound biomicroscopy revealed no connection between the multiple leaking holes and localized filtering bleb. CONCLUSION: Following trabeculectomy at the superior temporal quadrant, we should consider downward extension of the lacrimal gland as a possible source of a patient's complaint of epiphora.

Adult↗
PubMed2006

Progressive replacement of oral mucosa by conjunctiva in osteo-odonto-keratoprosthesis: preliminary observations.

PURPOSE: In a Strampelli osteo-odonto-keratoprosthesis, a patch of oral mucosa is frequently used to cover the ocular surface after implantation of an osteodental lamina into the eye. In many cases, gross modifications in the eye covering become apparent a few years later. The aim of this study was to investigate the histologic findings in the clinically modified ocular surface. METHOD: Biopsies were performed in 7 patients at the junction between the osteodental acrylic lamina and surrounding modified oral mucosa, during surgery for local plastic reconstruction or positioning of antiglaucoma silicone tubes. Specimens were examined by light microscopy. RESULTS: Six of the 7 clinically modified specimens corresponded microscopically to conjunctiva. Typical oral mucosa could still be observed overlying the osteodental acrylic lamina. CONCLUSIONS: The production of local regulatory factors is a possible explanation for the survival of oral mucosa over the osteodental acrylic lamina, whereas their absence in distant areas may have induced the oral mucosa to transdifferentiate into a conjunctival-type lining. Alternatively, conjunctival regrowth from forniceal stem cells should be taken into consideration.

Acrylates↗
PubMed2006

Identification of steroidogenic enzyme mRNAs in the human lacrimal gland, meibomian gland, cornea, and conjunctiva.

PURPOSE: Sex steroids exert a significant influence on the health and well-being of the ocular surface and adnexa. These hormones affect multiple aspects of the lacrimal and meibomian glands, conjunctiva, and cornea, and have been linked to the development of many ocular surface pathologies. We hypothesize that these hormone actions, as in other tissues, occur predominantly after the local synthesis of androgens and estrogens from adrenal precursors. To begin to test this hypothesis, we analyzed whether human ocular surface and adnexal tissues and cells contain the steroidogenic enzyme mRNAs necessary for the intracrine synthesis and metabolism of sex steroids. METHODS: Total RNA was isolated from human lacrimal and meibomian glands and immortalized corneal and conjunctival epithelial cells. Samples were reverse transcribed to cDNA and analyzed for the presence of enzyme mRNAs by real-time PCR. Positive and negative controls included human placental cDNA and the absence of template, respectively. RESULTS: Our results show that human lacrimal and meibomian glands and corneal and conjunctival epithelial cells contain the mRNAs for steroid sulfatase, 3beta-hydroxysteroid dehydrogenase (HSD)-Delta-Delta-isomerase type 1, 17beta-HSD types 1 and 3, aromatase, and glucuronosyltransferase. In contrast, only lacrimal and meibomian tissues appeared to contain detectable mRNA for sulfotransferase. CONCLUSIONS: If the corresponding mRNAs are translated, our results indicate that human ocular surface and adnexal tissues contain the enzymatic machinery necessary for the intracrine synthesis and metabolism of sex steroids.

17-Hydroxysteroid Dehydrogenases↗
PubMedDate not supplied

Microcirculation of the bulbar conjunctiva in the goat implanted with a total artificial heart: effects of pulsatile and nonpulsatile flow.

A new system to observe the microcirculation on the bulbar conjunctiva was developed using a digital high definition microscope to investigate the influence of the flow patterns on the microcirculation in a goat with a total artificial heart (TAH). The undulation pump TAH was implanted into the goat. When the whole body condition became stable, the flow pattern was modulated between the pulsatile and the nonpulsatile mode, and the changes in the microcirculation were observed. When the flow pattern was changed from pulsatile to nonpulsatile mode, the erythrocyte velocity in capillaries dropped from 526+/-83 to 132+/-41 microm/s and remained at a low level. The number of perfused capillaries decreased as well. Then the nonpulsatile flow mode was maintained for 20 minutes. After the flow pattern was returned to the pulsatile mode again, the erythrocyte velocity recovered to the initial level (433+/-71 microm/s). In many cases, the flow of the nonperfused capillaries in the nonpulsatile mode recovered to the initial level after the flow pattern was changed to the pulsatile mode again. The perfused capillary density in the nonpulsatile mode (19.7+/-4.1 number of capillaries/mm) was significantly lower than that in the pulsatile mode (34.7+/-6.3 number of capillaries/mm). It is thought that the basal and flow stimulated endothelium derived nitric oxide release in the microvessels decreased because of the disappearance of pulsatility and that the nitric oxide induced the constriction of arterioles after the flow pattern was changed to the nonpulsatile mode. At the same time, the baroceptors might sense the decrease in the arterial peak pressure or dp/dt, and the sympathetic nerve increases activities and induce the constriction of arterioles. Then, the erythrocyte velocity in capillaries would decrease. Because of the flow pattern further in the chronic phase, it is important to follow the change in the microcirculation.

Animals↗
PubMed2003

The bare area of the upper conjunctiva: a closer look at the anatomy of transconjunctival upper blepharoplasty.

Transconjunctival upper blepharoplasty is a novel technique for which the overall experience has been limited. The authors have used this technique in 42 patients for eyelid rejuvenation, with predictable results and low morbidity. The authors previously described the "bare" area in the medial upper conjunctiva, which was initially noted during their clinical series. This area serves as an anatomic window to access the medial upper eyelid fat pad with a high degree of safety. To clarify the anatomy of this approach, an anatomic study of the upper medial eyelid was performed on the orbits of 10 cadavers (20 orbits). The bare area was further elucidated during these dissections and its microscopic components described in detail. Its spatial relationship to the medial orbital wall and trochlea was also examined during this study. The authors hope that these findings will aid surgeons planning to use this technique.

Adipose Tissue↗
PubMed1991

Mycoplasma oxoniensis, a new species isolated from Chinese hamster conjunctivas.

Mycoplasmas which were distinct from Mycoplasma cricetuli were isolated from the conjunctivas of Chinese hamsters. Two clones, which were derived from a single colony and were obtained on separate occasions, were examined in detail for morphology, growth, and biochemical characteristics. These clones were indistinguishable from each other and had the following properties: guanine-plus-cytosine content of 29 mol%, requirement for sterol, facultatively anaerobic, and positive for glucose metabolism. They were serologically distinct from M. cricetuli and all 94 other previously described Mycoplasma and Acholeplasma spp. One of them, strain 128 (= NCTC 11712), is designated the type strain of a new species, Mycoplasma oxoniensis.

Animals↗
PubMed1996

Mycoplasma sturni sp. nov., from the conjunctiva of a European starling (Sturnus vulgaris).

Strain UCMF(T) (T = type strain) was isolated from the conjunctiva of a European starling (Sturnus vulgaris) with conjunctivitis. Colonies grown on conventional mycoplasma agar possessed the typical fried-egg appearance observed with many mycoplasmal species. Electron micrographs of ultrathin sections of UCMF(T) revealed a pleomorphic cellular morphology; the cells ranged from spherical to elliptical or flask shaped. The cell size ranged from 0.3 to 0.5 microns. Strain UCMF(T) grows well in a variety of mycoplasma broth formulations at 25 degrees C, with rapid and heavy growth at 37 degrees C. No growth occurs at 42 degrees C. This organism ferments glucose but does not hydrolyze urea or arginine and has an absolute requirement for sterol from growth. Strain UCMF(T) does not hemagglutinate or hemadsorb chicken erythrocytes. The genome size is 870 kbp, and the guanine-plus-cytosine content is 31 mol%. Sequence analysis of the 16S rRNA gene demonstrated that this organism is unique and has not been described previously. Serological analysis confirmed that strain UCMF(T) is distinct from all previously identified Mycoplasma, Acholeplasma, Spiroplasma, Entomoplasma, and Mesoplasma species. This organism represents a new species, for which we propose the name Mycoplasma sturni. Strain UCMF (= ATCC 51945) is the type strain of M. sturni sp. nov.

Animals↗
PubMed1993

Three cases of primary acquired melanosis of the conjunctiva as a manifestation of the atypical mole syndrome.

We report three patients with the atypical mole syndrome (AMS) [also known as dysplastic naevus or FAMMM syndrome] who presented with primary acquired melanosis (PAM). PAM is a melanocytic lesion of the conjunctiva which may progress to conjunctival melanoma. The association of this rare condition with the AMS phenotype in three individuals suggests that PAM may be a conjunctival manifestation of the AMS.

Adult↗
PubMed1995

The morphology of conjunctiva after long-term topical anti-glaucoma treatment. A quantitative analysis.

On biopsy material, differences in the degree of conjunctival inflammation and fibrosis between topically treated glaucoma patients and age matched controls, were examined histologically. Eighteen patients with primary glaucoma underwent goniotrephinations, because maximal medical therapy had failed. The patients had received at least two types of topical anti-glaucoma drugs for at least 12 months (mean 46 months). The control group consisted of 18 age-matched control patients without glaucoma, who had received no topical therapy. These patients underwent cataract surgery or squint surgery. Biopsies were taken from the infero-temporal bulbar quadrant with a biopsy forceps. The specimens were fixed while stabilized on a rubber support to exclude any major shrinkage. Specimens were analyzed by light microscopy for the content of inflammatory cells (plasma cells, lymphocytes, polymorphs, macrophages and mast cells), goblet cells and fibroblasts. No significant difference in the histologic parameters between the two groups could be demonstrated. The study suggests that topical treatment for periods up to 4 years with anti-glaucoma drugs does not induce morphological signs of inflammation and fibrosis of the conjunctiva.

Administration, Topical↗
PubMed1976

Congo red vital staining of cornea and conjunctiva.

Vital staining with an aqueous solution of 1% Congo red has been studied in the slit lamp. In 98 cases the dye was mixed with 1% lissamine green, in 120 eyes subsequent staining was performed with 0.125% fluorescein, and in 80 cases the mucous thread from the inferior conjunctival fornix was microscoped. Congo red stains dead cells, degenerate cells, and mucus. The dye discloses keratitis, corneal erosion, contact lens damages, corrosions, etc. It stains like lissamine green and rose bengal, though less frequently and less intensely than these. Congo red is a pH indicator. Acid reaction beyond its pH-range (3.0-5.2) has not been demonstrated. Amyloid-specific colour reaction (red-green dichromatic polarisation) has been noticed in mucous fibrils, most often in relation to infectious conjunctivitis and corrosion, never in normal eyes. The phenomenon is believed to indicate degeneration of the mucous fibrils (on the analogy of toluidine-blue-stained mucus), whereas not presence of genuine amyloid. It is, in other words, an important phenomenon in the differential diagnosis. Congo red is hardly indicated in ordinary clinical practice for vital staining of cornea and conjunctiva. Fluorescein, combined with rose bengal or lissamin green should be preferred.

Congo Red↗
PubMed1978

Spheroid degeneration of cornea and conjunctiva. Prevalence among Eskimos in Greenland and Caucasians in Copenhagen.

The incidence of spheroid degeneration has been studied in a series of 659 Eskimos from Arctic South-West Greenland and one of 810 Caucasians in Copenhagen with its temperate climate. The over-all prevalence was highest among the Eskimos (12.3% against 4.1% among the Copenhageners, P less than 0.001). The prevalence was found to be independent of sex, but to rise with increasing age (however, with a fall again after the age of 70 years in Copenhagen). The spheroid deposits were present on the conjunctiva in 74%, on the cornea in 18%, and at both sites in 8%. 71% of the subjects displayed autofluorescent globular deposits. These constituted 10% of the total number of globules. The number of globules per subject averaged 30. Spheroid degeneration was rarely found temporally in Eskimos. Spheroid degenerative processes are most frequently seen in pingueculae, but are not considered bear any relation to pterygium.

Adolescent↗
PubMed1978

Vital staining properties of neutral red. Vital staining of cornea and conjunctiva.

Vital staining by instillation in the conjunctival sac of 1% neutral red in 54 normal and 153 differently affected eyes was studied by slit lamp examination. Of these, 134 eyes were after-stained by a mixture of 1% tetrazolium and 1/4% alcian blue and 73 eyes were after-stained by a mixture of 1% rose bengal and 1% fluorescein. Microscopy of a further 10 conjunctival scrapings and 40 mucous conjunctival threads disclosed neutral-red-stained inclusion bodies in the cytoplasm of the epithelial cells and the granulocytes. In the slit lamp the cornea and the conjunctiva were seen to be stained only rarely and, if so, poorly by neutral red, both in normal and affected eyes. Better staining was obtained with tetrazolium, and the best with rose bengal. The plica semilunaris, Marx' line, and the mucous thread were stained by neutral red, more intensely by rose bengal, and the least by tetrazolium. The inferior fornix and the tarsus were rarely stained by any of the three dyes. Neutral red seems to offer no diagnostic advantages over the vital stains with which the dye has been compared in the present study. More particularly we found no pathological processes that were stained more intensely by neutral red than by the other vital stains.

Cataract↗
PubMed1979

Phagocytosis of latex microspheres by the epithelial cells of the guinea pig conjunctiva.

The capability of conjunctival epithelial cells to phagocytize particulate foreign matter was studied experimentally in the guinea pig. Perilimbal conjunctival epithelium was prepared for transmission electron microscopy by perfusion fixation 4 and 24 h after instillation of latex microspheres (0.79 mu in diameter) into the lower conjunctival fornix. A varying number of microspheres were internalized by the superficial epithelial cells in both cases. The intracellular microspheres, single (at 4 and 24 h) or aggregated (only at 24 h), were always membrane-enclosed, corresponding to primary phagosomes. Some indications of secondary phagosomes were seen as well. In the 24 h specimens, microspheres were present also in the intermediate epithelial cells, implying a transfer from superficial to deeper cells. Thus, superficial as well as intermediate epithelial cells of the guinea pig conjunctiva are capable of active phagocytosis of inert particles.

Animals↗
PubMed1985

The oxygen tension and temperature of the superior palpebral conjunctiva.

A Clark-type oxygen sensor and temperature-sensing thermistor embedded in a ring designed to fit into the human palpebral aperture were used to directly measure the oxygen tension and temperature of the upper palpebral conjunctiva in 16 human subjects. The mean oxygen tension was found to be 61.4 +/- 6.9 mmHg, equivalent to an atmosphere of 8.2% oxygen, slightly higher than previously reported. The mean temperature was 36.2 +/- 0.6 degrees C, in good agreement with previous findings. Significant individual differences in both oxygen tension and temperature were apparent.

Adolescent↗
PubMed1986

Detection of mucus glycoconjugates in human conjunctiva by using the lectin colloidal gold technique in TEM. I. A quantitative study in normal subjects.

We applied a specific cytochemical reaction to characterize the glycoconjugates produced by goblet and non-goblet epithelial cells of normal human conjunctiva. For this purpose we utilized the lectins, proteins of vegetal origin, which are extremely sensitive in binding glycosidic residues. In particular, we used WGA, PNA, SBA and ConA conjugated with colloidal gold as ultrastructural marker for Transmission Electron Microscopy. This technique allowed us also to perform a quantitative analysis, by counting colloidal gold particles present on mucus granules. In this way we analyzed the content both of goblet and non-goblet epithelial cells. In the former, WGA, PNA, SBA and ConA receptors, here reported in decreasing density, were present. In the latter WGA was always positive, SBA and PNA sometimes were negative, ConA was always negative. We speculate the different contribution to mucus production by these two sources may be important in evaluating tear film stability alterations occurring in those diseases in which non-goblet epithelial cell vesicles increase.

Carbohydrate Metabolism↗
PubMed1987

Effect of multiple applications of compound 48/80 on mast cells of rat conjunctiva.

We sought to determine the effect on rat conjunctival mast cells of chronic exposure to a degranulating agent. Compound 48/80 (250 micrograms in 10 microliter) was applied daily to the ocular surface of rats for a total of 13 treatments administered in 17 days. A single application of compound 48/80 was given to rats for comparison. Four groups of animals (6 in each group) were evaluated 1 or 48 h after the last application of compound 48/80 in both chronic exposure and single exposure studies. Although a single exposure to compound 48/80 induced significant degranulation of mast cells in animals observed 1 h after treatment, no significant degranulation of mast cells was observed 1 h after the last dose of compound 48/80 was given to rats whose conjunctiva had been chronically exposed to this degranulating agent. Thus, multiple applications of compound 48/80 attenuated the mast cell response to compound 48/80. This acquired tolerance to compound 48/80 was reflected in the lessened clinical signs in rats receiving repeated applications compared with those given a single application.

Animals↗