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Palpebral form- Usually upper tarsal conjunctiva of both the eyes is involved. Typical lesion is characterized by the presence of hard, flat-topped papillae arranged in cobblestone or pavement stone fashion. In severe cases papillae undergo hypertrophy to produce cauliflower-like excrescences of 'giant papillae'.
The conjunctival inflammation is called "active trachoma" and is usually seen in children, especially those in preschool. It is characterized by white lumps in the undersurface of the upper eyelid (conjunctival follicles or lymphoid germinal centers) and by nonspecific inflammation and thickening, often associated with papillae.
Palpebral or tarsal conjunctiva Lines the eyelids Bulbar or ocular conjunctiva Covers the eyeball, over the anterior sclera: This region of the conjunctiva is tightly bound to the underlying sclera by Tenon's capsule and moves with the eyeball movements. The average thickness of the bulbar conjunctival membrane is 33 microns.
Viral conjunctivitis manifests as a fine, diffuse pinkness of the conjunctiva which may be mistaken for iritis, but corroborative signs on microscopy, particularly numerous lymphoid follicles on the tarsal conjunctiva, and sometimes a punctate keratitis are seen. [citation needed]
The eyelid is made up of several layers; from superficial to deep, these are: skin, subcutaneous tissue, orbicularis oculi, orbital septum and tarsal plates, and palpebral conjunctiva. The meibomian glands lie within the eyelid and secrete the lipid part of the tear film.
The conjunctiva is a tissue that lines the inside of the eyelids and covers the sclera. It is composed of unkeratinized, stratified squamous epithelium with goblet cells, and stratified columnar epithelium. The conjunctiva is basically transparent, and the white colour we see is actually sclera.
It consists of skin, hair follicles, sebaceous glands, sweat glands, accessory lacrimal tissue and other tissues that are present in the skin and accessory lacrimal glands. [1] [2] Its non-keratinized epithelium resembles the conjunctival epithelium. [2]
Meibomian glands (also called tarsal glands, palpebral glands, and tarsoconjunctival glands) are sebaceous glands along the rims of the eyelid inside the tarsal plate. They produce meibum , an oily substance that prevents evaporation of the eye's tear film .