The outer covering of the visual organ is the conjunctiva eyeball, which may be subject to mechanical damage and others negative impacts. The mucous or conjunctival membrane is located from the extreme area of the eyelids to the cornea. This ocular structure performs various functions, but mainly it serves as a protective layer and stabilizes the functioning of the eyes, is responsible for the synthesis of mucin and the functioning of the lacrimal glands. If the conjunctiva becomes inflamed, changes color, folds or other abnormalities appear on it, it is recommended to contact an ophthalmologist as soon as possible and not delay treatment.
Anatomy and functions
The conjunctiva or mucous membrane of the eye is the most vulnerable structure of the visual organ, since it is exposed to various external factors. With its help, the upper and lower arches, which are blind pockets, are formed. Thanks to the latter, the eyeball can move freely. The conjunctiva has the following functional features:
- Thanks to the multilayered epithelial tissue on the surface, it is possible to protect the eyeball from injury and other damage. The cells create protection against foreign body entry.
- The production of exudate by the lacrimal glands, through which small particles are removed from the conjunctiva.
- Protection against pathogenic microorganisms due to the production of lysozyme and immunoglobulins by glandular cells. With their help, it is possible to reduce the likelihood of inflammatory reactions in the eyeball area.
Characteristics and structure
The structure of the mucous membrane of the organ of vision consists of the conjunctiva and eyelid, which are interconnected and complement each other.
The surface of the mucous membrane of the eyeball is divided into the conjunctiva of the eye and the eyelid. When the latter close, the membranes join, resulting in the formation of the lower or upper fornix of the conjunctiva. In the structure of the eye structure there is a rudimentary formation, which in ophthalmology is also known as the third eyelid. The duplication forms a kind of semilunar fold. It is localized in the area of the medial angle of the visual organ.
In some nationalities, especially the Mongoloid type, the rudimentary formation is more pronounced than in others, which gives the eyes greater expressiveness.
By histological structure There are bulbar, palpebral conjunctiva and the mucous membrane of the fornix. The following layers of cells of the visual organ are distinguished:
- Epithelial, which includes squamous epithelium with several layers containing various glands.
- Subepithelial. Consists of loose connective tissue, lymphocytes and large number glandular cells.
A lot of blood enters the conjunctiva through the arteries of the eyelids. During inflammatory reactions, transitional colors from white to deep red can be observed. This phenomenon is associated with the expansion of a large number of blood vascular plexuses. Also various diseases conjunctiva can lead to disruption of sensory innervation. The patient may experience unpleasant symptoms, such as frequent blinking.
Why does it develop and what symptoms accompany the pathology?
Due to its location on the surface of the eye, inflammatory processes often occur, one of which is conjunctivitis. The conjunctiva of the eyelids and sclera are often exposed various diseases, a fold may form on it, change color and other pathologies may occur. This is due to the fact that it is located at the very top of the mucous membrane of the eyeball. To a greater extent, the diseases are inflammatory in nature and are known in ophthalmology as conjunctivitis. The disease comes in several types, affecting the tarsal conjunctiva and other parts of the ocular structure. The following reasons can affect the disease:
- contact with the mucous membrane of the eyeball by bacteria, viruses and other infections;
- mechanical damage;
- allergic reaction to eye drops, plant pollen or animal hair;
- unsuitable contact lenses, causing allergies;
- negative impact on the conjunctiva of household cosmetics, disinfectants, and polluted air.
When the conjunctiva or cornea becomes inflamed, the patient experiences pain in the eyes and other unpleasant symptoms, which may appear stronger or weaker, depending on the form and type of the disease. The disease can be recognized by the following signs:
- pain when blinking;
- dilated conjunctival vessels, as a result of which the mucous membrane of the eyeball turns red;
- itching and burning sensations;
- purulent and other pathological discharge from the eyes, which should not normally be present;
- neoplasms on the conjunctiva or in the lower eyelid area;
- drying out of the mucous membrane against the background of dystrophic changes.
Ophthalmologists diagnose inflammation of the conjunctival membrane of unknown etiology if the cause of the disease cannot be determined.
Diagnostic measures
If undesirable manifestations occur on the organs of vision, you must consult a doctor who will conduct an examination and determine the disease. If the conjunctiva does not completely cover the eyeball, its anatomy is disturbed or there are other disorders that negatively affect the eyeball. visual function, then you should immediately contact an ophthalmologist. Also, medical consultation is required in case of an inflammatory reaction, redness of the mucous membrane of the eye and the presence of other unpleasant symptoms. In most cases, a visual examination of the eyeball or the use of ophthalmological equipment is sufficient for a specialist. If you establish an accurate diagnosis and find out why the bulbar conjunctiva or other ocular structures are inflamed, then the following diagnostic procedures are prescribed:
- ultrasound diagnostics of the eyeball;
- biomicroscopy, which involves examining the visual organs using a slit lamp;
- bacteriological laboratory tests pathological discharge, through which it is possible to identify pathogenic microflora.
Pterygium is formed from conjunctival tissue that has undergone degenerative changes, and grows from the limbus towards the middle of the cornea. Pterygium may have different sizes- from a couple of millimeters to large formations that cover the cornea and significantly reduce the patient’s quality of life.
What is a pterygium?
Pterygium, or pterygoid hymen, is an abnormal formation located on the inner corner of the eye, having a triangular shape.
The development of pathology can be rapid, characterized by rapid growth, or slow.
Prevalence
Epidemiology is directly related to a person’s place of residence. For example, in the United States, in those geographic areas that are above 40 degrees latitude, the prevalence of pathology does not exceed 2% of 100% of the population.
IN populated areas, located at a latitude of 28-36 degrees, the incidence increases to 10%.
According to experts, this is due to an increase in the amount of solar radiation received by humans. 
In females, the pathology develops less frequently than in males, which is due to the more frequent exposure of males to the scorching rays of the sun due to their type of work. The first signs of pterygium are usually observed at a young and mature age (25-40 years). Before the age of 20, the disease is rarely recorded.
Causes of the disease
The causes of the development of the disease are: high frequency and duration of exposure to ultraviolet radiation on the eye area, which is typical for residents of regions with hot climates, work in open areas, neglect of methods and means of eye protection. A hereditary predisposition to the appearance of signs of pterygium has also been proven.
Symptoms of pterygium
On early stages illness, any symptoms may be completely absent. Later, signs of eye irritation develop, redness of the conjunctiva, a feeling of the presence of sand, “fog” in the eyes, swelling of the eyelids, and a slight decrease in visual function. 
Diagnostic methods
An examination by an ophthalmologist includes testing visual acuity and visual inspection using a special lamp. If myopia and astigmatism occur, keratotopography is prescribed. Dynamic tracking of ongoing processes allows one to calculate the rate of disease development.
Consequences and complications
Among the unpleasant symptoms that may appear as pterygium progresses are:
- incomplete vision of objects, distortion of their outlines;
- significant loss of vision;
- pain in the eyes, severe irritation, inflammation of the conjunctiva due to rubbing, scratching;
- the appearance of adhesions, scars on the cornea, eyelids, etc.;
- fusion of pterygium tissue with other parts of the organ of vision, decreased mobility of extraocular muscles, as a result of which the eyeball may lose mobility;
- doubling of objects ().
The phenomena of diplopia most often develop due to partial paralysis of the external muscle. If the patient has suffered surgery Regarding pterygium, such unpleasant consequences can be observed as a result of separation of the muscle tendon from the area of its attachment.
A rare complication of pterygium is degeneration of the cornea with pronounced thinning, which is observed against the background of regular contact of the cornea with the protruding part of the formation.
The most dangerous, but rarest consequence of the disease may be its degeneration into a malignant tumor.
Treatment of pterygium
To reduce the rate of progression of the disease, drops such as “artificial tears”, moisturizing gels and ointments are used. Patients are recommended to constantly wear glasses with UV filters when outdoors. To eliminate the symptoms of pterygium, use eye ointments and drops with glucocorticosteroids.
Surgical treatment
A radical way to eliminate formation in the area of the inner corner of the eye is surgery. It is performed to restore the aesthetic appeal of the face, as well as for therapeutic purposes (to normalize visual acuity, eliminate discomfort, irritation and other symptoms).
Surgical removal of pterygium can be performed according to various techniques, but all of them are aimed at excision of abnormally overgrown tissue.
It was noted that removal of pterygium without subsequent drug treatment leads to its reappearance in half or more cases.
To prevent this from happening, immediately after the operation they are treated with immunosuppressants (cytostatics), courses of β-irradiation therapy are carried out, the affected area is treated with cryocoagulants, etc.
If postoperative therapy was carried out in to the fullest, the probability of recurrence of pterygium is no more than 10%.
If the pterygium is of significant size, it may be necessary to transplant (glue or sew in) a conjunctival autograft or special artificial membranes to hide the resulting cosmetic defect.
The operation is not complicated and is often performed under local anesthesia. In parallel with anti-relapse treatment, it is prescribed antibacterial therapy, drops to prevent inflammation.
In some cases, the operation leads to the development of complications. These may be: infection of the eye, transplant rejection, inflammation of the tissue in the suture area, visual dysfunction (for example, double vision), the appearance of scars on the cornea of the eye.
The rarest, but still occurring complications are perforation of the eyeball, penetration of blood into vitreous. During treatment with cytostatics and radiation therapy The cornea may become thinner, and sometimes scleral ectasia occurs.
The conjunctival membrane is a covering layer that is located around the eyeball. The mucous membrane originates at the marginal surface, and then moves to the eyeball itself and reaches. If the patient everts the eyelid, the conjunctiva becomes accessible for inspection.
The structure of the conjunctiva of the eye
The entire surface of the ocular mucosa can be divided into two sections:
- Conjunctiva of the eyeball;
- Conjunctiva of the eyelid.
When the eyelids are closed, the conjunctiva joins to form two bags (lower and upper). If the eyelids are open, the mucous membrane forms two corresponding arches. There is also a rudimentary formation, which is called the third century. It is located in the medial corner of the eye and is better expressed in some nationalities, in particular the Mongoloid type. This fold was well expressed among our ancestors, but over time it lost its purpose.
From a histological point of view, the conjunctiva consists of two layers of cells:
1. The epithelial layer includes stratified squamous epithelium, which contains large number glandular cells.
2. The subepithelial layer includes loose connective tissue, lymphocytes and a small number of glandular cells.
The mucous membrane of the eye is very well supplied with blood. The blood flow comes from the arteries of the eyelids, as well as from the ciliary arteries. If an inflammatory process develops in the area of the surface of the eye, the mucous membrane acquires a red tint. This is due to the expansion of an abundant number of blood vessels. In addition, when inflammatory process arise painful sensations, which is associated with irritation of the twigs trigeminal nerve. In addition, it is possible to develop so-called referred pain, which is caused by the involvement of inflammatory reactions of other branches of the trigeminal nerve. In particular, pain that occurs with diseases of the ENT organs can radiate into the eye.
Physiological role of the conjunctiva of the eye
The main functions of the conjunctiva are related to the structure of this membrane of the eye:
1. The protective role is associated with the presence of multilayered epithelium on the surface. These cells protect the eyeball itself from small foreign objects.
2. produce fluid, which also helps remove small particles from the surface of the mucous membrane.
3. Lysozyme produced by glandular cells, as well as immunoglobulins, provide protection against pathogenic flora and reduce the risk of developing a inflammatory reaction.
Video about the structure of the conjunctiva of the eye
Symptoms of damage to the conjunctiva of the eye
The immediate manifestations of conjunctival pathologies depend on the pathological process. Among them are:
- Pain in the eye area, aggravated by blinking movements;
- conjunctiva due to vasodilation;
- Change in the nature of the discharge (appearance of pus, etc.);
- and burning;
- Increased fluid intake;
- Neoplasm on the surface of the conjunctiva;
- Dry mucous membrane associated with dystrophy.
Diagnostic methods for damage to the conjunctiva of the eye
A number of studies are used to diagnose pathologies of the mucous membrane:
- (performed using a slit lamp);
- Bacteriological examination of discharge for the presence of infectious agents.
It should be noted once again that the conjunctiva refers to important bodies optical system and protects the eyeball from external damage. In addition, due to the presence of lysozyme and immunoglobulins, the conjunctiva is able to resist pathogenic microflora.
Diseases of the conjunctiva of the eye
Among the pathologies that may affect the conjunctival membrane are:
- , which consists in the formation of a wen on the surface of the mucosa;
- is an inflammatory reaction that is associated with invasion of pathogenic microorganisms or an allergic attack.
- Tumors of a benign or malignant nature (fibroma, nevus, etc.).
- Keratoconjunctivitis sicca, which is a sign of degenerative processes.
The main role of the conjunctiva is to protect against external factors and provide comfort, which is achieved through the work of numerous glands that produce mucin, as well as additional lacrimal glands. The production of mucin and tear fluid creates a stable tear film that protects and moisturizes the eye. Therefore, with diseases of the conjunctiva, for example, conjunctivitis, severe discomfort appears in the form of a burning sensation, foreign body or sand in the eyes.
Structure of the conjunctiva
The conjunctiva is a thin, transparent mucous membrane covering back surface the eyelid, where it connects very tightly with cartilage, further forms the conjunctival vaults: upper and lower.Fornixes are areas of relatively free conjunctiva that look like pockets and provide freedom of movement of the eyeball, with the upper fornix being twice as large as the lower one. The conjunctiva of the fornix passes onto the eyeball, located above the dense Tenon's membrane, reaching the limbus. In this case, the epithelium of the conjunctiva - its surface layer directly passes into the epithelium of the cornea.
The blood supply to the conjunctiva of the eyelids is provided by the same vessels as the eyelids themselves. In the conjunctiva of the eyeball, there are superficial and deep layers of vessels. The superficial one is formed by the perforating arteries of the eyelids and the anterior ciliary arteries. The deep layer of conjunctival vessels is formed by the anterior ciliary arteries, forming a dense network around the cornea.
The venous vascular system corresponds to the arterial system. In addition, the conjunctiva is rich in accumulations of lymphoid tissue and lymphatic vessels. The sensitivity of the conjunctiva is provided by the lacrimal, subtrochlear and infraorbital nerves.
Symptoms of the lesion
The conjunctiva, as a mucous membrane, reacts to any external irritation with inflammation. The irritant may be temperature, allergens, chemicals and most often, bacterial or viral infection. The main manifestations of inflammation of the conjunctiva are: lacrimation, redness, itching, burning or dryness, pain when blinking and moving the eyeball with an increase in the lymphoid tissue of the conjunctiva of the eyelids. The sensation of a foreign body may appear when the cornea is involved in the process. Discharge from the eyes during inflammation of the conjunctiva can be different: from watery-mucous to purulent with crusts, depending on the damaging irritant agent. With acute viral infections, hemorrhages may appear under the conjunctiva, and it becomes swollen.
With insufficient function of the lacrimal glands and certain cells, the conjunctiva can dry out, which leads to various degenerative conditions. The conjunctiva of the eyeball, the fornix, and then the eyelids can grow together, limiting the movements of the eyeball.
Normally, the conjunctiva does not extend to the cornea, but in some people, especially with windy environment and/or dusty work, there is a slow growth of the conjunctiva on the cornea area and upon reaching a certain size. This growth, called a pterygium, can reduce vision.
The conjunctiva may normally contain pigment inclusions in the form of brownish-dark spots, but they must be observed by an ophthalmologist.
Diagnostic and treatment methods
For a detailed examination of the conjunctiva, an ophthalmologist requires a slit lamp examination. At the same time, the conjunctiva of the eyelids, eyeball and fornix, the degree of expansion of its vessels, the presence of hemorrhages, swelling, the nature of the resulting discharge, and the involvement of other ocular structures in the inflammatory or degenerative process are assessed.Treatment for conjunctival diseases depends on their cause. From rinsing and antibacterial and anti-inflammatory treatment for chemical burns, for infections up to surgical treatment with pterygium and symblepharon.
The conjunctiva is divided into two sections: the conjunctiva of the eyelids and the eyeball. At the transition points it forms two arches, and at closed eyes two closed cavities - conjunctival sacs(the space between the upper and lower eyelids and the eyeball). These anatomical formations are introduced medicinal substances in the form eye drops or ointments. In the inner corner of the eye, the conjunctiva forms a semilunar fold and the lacrimal caruncle (a vestige of the third century, inherited from our ancestors).
The conjunctiva has two layers: epithelial and subepithelial. The epithelial layer consists of multilayered epithelium with a large number of glandular cells (the lacrimal glands of Krause, Wolfirng, mucin-producing glands (Manza), the secretion of which moisturizes and disinfects the mucous membrane of the eye. The subepithelial layer is represented by loose tissue with the inclusion of glands and the accumulation of lymphoid tissue.
Innervation and blood supply
The conjunctiva receives blood supply from the vessels of the eyelids, as well as from the anterior ciliary vessels, which form two layers: superficial and deep. At inflammatory diseases or irritation, a reflex dilation of the vessels of the mucous membrane occurs - the eyes “turn red” (conjunctival hyperemia).
The mucous membrane of the eye has sensitive innervation (branches of the trigeminal nerve).
Functions
The main function of the conjunctiva is protective. With the help of tears and the substances it contains (mucin, lysozyme, immunoglobulins), small particles are removed from the surface of the eyeball. foreign bodies and bacteria, the cornea is moistened.
Diseases
Diseases of the conjunctiva can be divided into three groups, according to the reasons that cause them:
1. Infectious: viral or bacterial.
2. Allergic conjunctivitis: to pollen, medications, cosmetics, animals, etc.
3. Dystrophic diseases of the conjunctiva: (wen), keratoconjunctivitis sicca, etc.
4. Neoplasms of the conjunctiva (malignant and benign): nevi, cysts, fibromas.
