presented by dr. arvind kumar (g.r.m.c., gwalior, m.p.)

1. DR. ARVIND KUMAR

2. 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 )

3. Conjunctiva
Palpebral
Conjunctiva
Marginal Tarsal Orbital
Bulbar
Conjunctiva
Scleral Limbal
Conjunctival
Fornix

5. Palpebral
Conjunctiva
Marginal
Tarsal
Orbital

6. Marginal Conjunctiva
 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
 It is actually a transitional zone between skin and the
conjunctiva proper.

7. Tarsal Conjunctiva
 Firmly adherent to the tarsal plate
 Thin+transparent+highly vascular structure
 Meibomian glands appear as yellow streaks through
the tarsal conjunctiva

8. Orbital 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

9. Bulbar
Conjunctiva
Scleral
Limbal

10. Scleral Conjunctiva
 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

11. Limbal Conjunctiva
 3mm ridge around the cornea
 Conjunctiva, Tenon’s capsule and episcleral tissue are
fused together
 Strongly adherent to sclero-corneal junction

12. Conjunctival Fornix
 Joins the bulbar and palpebral conjunctiva
 Ducts of the lacrimal gland open into the lateral part
of superior fornix

14. Epithelium
Adenoid
Layer
Fibrous
Layer
Substantia
Propria

15. Conjunctiva Number of layers Cells in the layers
Marginal
5 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

17.  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

18.  Has Collagenous fibres + Elastic fibres
 Thicker than adenoid layer except in the Tarsal
Conjunctiva
 Lodges the Conjunctival vessels and nerves

19. Mucin Glands
Goblet Cells
Henle’s
Glands
Glands of
Manz
Accessory
Lacrimal Glands
Glands of
Krause
Glands of
Wolfring
Rudimentary
A.L.G.

20.  Unicellular round or oval mucous glands
 Absent in the Marginal & Limbal conjunctiva
 These cells are destroyed after discharging the
contents

21. Goblet Cell Density
Numerous on nasal
side
High in children and
young adults

22.  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

23.  Located in the scleral conjunctiva
 Arranged in a ring around the cornea, near
the scleral junction

24. Mucin Glands

25.  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

26.  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.

27.  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

28. Accessory Lacrimal Glands

30. Marginal Tarsal Arcade
Peripheral Tarsal Arcade
Anterior Ciliary Arteries

32. The veins from the conjunctiva drain into the
venous plexuses of eyelids which in turn drain
into the superior or inferior ophthalmic veins.
A circumcorneal zone of veins about 5-6 mm
from the limbus drain into the anterior ciliary
veins.

33. Lymphatics from the lateral
side drain into preauricular
lymph nodes and those from
the medial side into the
submandibular lymph
nodes.

34. • Bulbar conjunctiva – long ciliary nerves – naso ciliary N.-
Ophthalmic division of trigeminal N.
•Superior palpebral and forniceal conjunctiva – frontal and
lacrimal branches of Ophthalmic division of trigeminal N.
•Inferior palpebral and forniceal conjunctiva – laterally from
lacrimal branches of Ophthalmic division of trigeminal N. and
medially infraorbital N. – maxillary division of trigeminal N.