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Detailed yet simple presentation which I suppose to be useful for a quick knowledge on "Anatomy & Histology of Conjunctive"
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ANATOMY OF CONJUNCTIVA
-K.MOHAN RAM
Conjunctiva
Thin, transparent, mucous membrane lining the posterior aspect of eye lid & anterior aspect of eye ball
Latin : conjoin – to join ( it joins the eye ball to the eye lid )
Conjunctiva
Palpebral Conjunctiva
Marginal Tarsal Orbital
Bulbar Conjunctiva
Scleral Limbal
Conjunctival Fornix
PartsOf
Conjunctiva
Palpebral Conjunctiva
Marginal
Tarsal
Orbital
Extends from the lid margin ( opening of tarsal gland ) to the sulcus subtarsalis
Sulcus subtarsalis ◦ Marks the inferior edge of the tarsal plate◦ Shallow groove situated 2mm from lid margin
Lacrimal puncta open in the marginal zone
Marginal Conjunctiva
Firmly adherent to the tarsal plate
Thin+transparent+highly vascular structure
Meibomian glands appear as yellow streaks through the tarsal conjunctiva
Tarsal Conjunctiva
Extends from the upper border of the tarsal plate to the fornix
Loosely attached to the superior tarsal muscle [Müller’s muscle] and so folds readily
Shallow grooves and elevations are called Stieda’s plateaux and grooves
Orbital Conjunctiva
Bulbar Conjunctiva
Scleral
Limbal
Thin, transparent & loosely attached to underlying sclera
Permits the visualization of Conjunctival and episcleral vessels
Separated from the sclera by episcleral vessels and Tenon’s capsule
Scleral Conjunctiva
3mm ridge around the cornea
Conjunctiva, Tenon’s capsule and episcleral tissue are fused together
Strongly adherent to sclero-corneal junction
Limbal Conjunctiva
Joins the bulbar and palpebral conjunctiva
Ducts of the lacrimal gland open into the lateral part of superior fornix
Conjunctival Fornix
HISTOLOGY OF
CONJUNCTIVA
Epithelium
Adenoid Layer
Fibrous Layer
Substantia Propria
Layers Of Conjunctiva
Conjunctiva Number of layers Cells in the layers
Marginal5 layered non-keratinised
stratified squamous epithelium
Superficial layer: Squamous cells
Middle three layers: Polyhedral cells
Deepest layer: Cylindrical cells
Tarsal and Orbital 2 layers of Stratified cuboidal epithelium
Superficial layer: Cylindrical cells
Deepest layer: cuboidal cells
Fornix and Scleral 3 layers of Stratified, squamous epithelium
Superficial layer: Cylindrical cells
Middle layer: polyhedral cells
Deepest layer: Cuboidal cells
Limbal 10 layers of stratified squamous epithelium
Superficial layer: squamous cells
Middle layer: polygonal cells
Basal- cubical
Goblet Cells Melanocytes Langerhan’s Cells CALT MALT
Cells Present In Epithelium
Also called Lymphoid layer
Consists of fine connective tissue reticulum in the meshwork of which lies the lymphocytes
Not present at birth , develops after 2-3 months of life
Adenoid Layer
Has Collagenous fibres + Elastic fibres
Thicker than adenoid layer except in the Tarsal Conjunctiva
Lodges the Conjunctival vessels and nerves
Fibrous Layer
Mucin Glands
Goblet Cells
Henle’s Glands
Glands of Manz
Conjunctival Glands
Unicellular round or oval mucous glands
Absent in the Marginal & Limbal conjunctiva
These cells are destroyed after discharging the contents
Goblet Cells
Goblet Cell Density
Numerous on nasal side
High in children and young adults
Not true glands
Tubular structure which contains a few goblet cells
Present in the folds of mucous membrane present in palpebral conjunctiva between tarsal plate & fornices
Resembles the Crypts of Lieberkuhn in large intestine
Henle’s Gland
Located in the scleral conjunctiva
Arranged in a ring around the cornea, near the scleral junction
Glands of Manz
Mucin Glands
Provide a hydrophilic layer that allows for even distribution of the tear film
Ensures tear film stability by reducing the surface tension
Provides lubrication and protects the epithelial cells of cornea and conjunctiva
Functions Of Mucin
Lie in deep sub - conjunctival tissue of the upper and lower fornices
42 in number in upper fornix and 6 to 8 in lower fornix
In upper fornix they lie between the palpebral part of the lacrimal gland and tarsal plate.
Glands of Krause
Also called Glands of Ciaccio, larger than Glands of Krause
Situated in the upper border of the tarsus midway between the end of the tarsal glands
2 to 5 in the upper lid and 1-3 in the lower lid
Glands of Wolfring
Accessory Lacrimal Glands
Blood Supply , Lymphatics
& Innervation
Of the Conjunctiva
Blood Supply
Marginal Tarsal Arcade
Peripheral Tarsal Arcade
Anterior Ciliary Arteries
Arterial Supply
Venous Drainage
Lymphatic Drainage
Nerve Supply
Applied Anatomy
Conjunctivitis
Conjunctivochalasis
Pinguecula
Pterygium
Rougine
Subconjunctival
hemorrhage