The conjuntiva and scarring

Published on May 31, 2016   26 min
Today, I'm going to talk to you about the conjunctiva and scarring. I'm Professor Sir Peng Khaw, and I'm presenting this to you, together with Garima Sharma from Moorfields Eye Hospital and the University College London Institute of Ophthalmology.
Today, we're going to do an overview of the conjunctiva, the anatomy and the role of this tissue. A quick word about some of the diseases of the conjunctiva, and then, I'll move into conjunctival scarring, the different phases of wound healing, the mediators the scarring, the wound-healing pathways, how we modulate wound healing, and then just a brief word about future prospects for improving the outcomes of conjunctival scarring.
This slide shows the anatomy and some description about the function of the conjunctiva. Although the conjunctiva is traditionally seen just as a covering, essentially for the eyeball and the inside of the eyelids, it has several very important sections. There's the bulbar conjunctiva, which covers the sclera, the palpebral, which covers the inner lining of the eyelids, and, of course, the fornix. Deep between the two are the inner reaches of the eyelid, which forms the junction between the eyelid and the eyeball. The conjunctiva is extremely important. Obviously, it forms a protective layer. It allows for lubrication because constantly, the eyeball and the eyelids are moving. And so, therefore, the elements produced by the conjunctiva are very, very important in terms of lubricating and keeping the conjunctiva and the cornea healthy. In this diagram, you'll see various glands which secrete a fluid and also various important components such as mucin, which maintain the multiple layers of the tear film and therefore keep the anterior surface of the cornea intact, without which the vision will be severely impaired. It's important to note that there's the tarsal plates, which form the relatively stiff backbone of the eyelids, both upper and lower. And within these lie the meibomian glands, which secrete the lipid, which form the outer layer of the tear film, which prevent excessive drying of the tear film and therefore discomfort in people who have problems with meibomian gland secretion and inflammation.