title: In vivo confocal microscopy of normal conjunctiva and conjunctivitis.
abstract: OBJECTIVE
  To analyze the appearance of normal conjunctiva and conjunctival inflammation by in vivo confocal microscopy.
  
  
  METHODS
  Conjunctiva of 15 normal patients and 21 patients with conjunctivitis including bacterial, papillary, follicular, granulomatous, and cicatrizing disease were analyzed by the Heidelberg retina tomograph (HRTII)/Rostock cornea modul (RCM).
  
  
  RESULTS
  Scans of normal bulbar and tarsal conjunctiva corresponded well to the established anatomy except for a prominent, thickened epithelial basement membrane observed by in vivo microscopy. Presumed goblet cells were visible throughout the conjunctival epithelium. Adenoid structures and hair follicles were discernible in the tarsal conjunctiva in vivo. Conjunctival perfusion could be observed directly. Acute and chronic inflammatory cells, conjunctival papillary, and follicular reactions, as well as conjunctival cicatrization, could be discriminated. In a patient with conjunctival granuloma, in vivo confocal microscopy disclosed suture material inside the lesion.
  
  
  CONCLUSIONS
  Confocal microscopy using near-infrared laser light is a useful new tool in the analysis of conjunctival tissue in vivo. It is a valuable aid in the differential diagnosis of conjunctival inflammation and thus may guide therapeutical decisions.
authors.affiliation: Department of Ophthalmology, Ludwig-Maximilians-University, Munich, Germany. emessmer@med.uni-muenchen.de
authors.forename: Elisabeth M
authors.initials: EM
authors.lastname: Messmer
authors.forename: Marc J
authors.initials: MJ
authors.lastname: Mackert
authors.forename: Daniel M
authors.initials: DM
authors.lastname: Zapp
authors.forename: Anselm
authors.initials: A
authors.lastname: Kampik
mesh_terms: D000328:Adult; D000368:Aged; D003228:Conjunctiva / Q000166:cytology*; D003231:Conjunctivitis / Q000473:pathology*; D004848:Epithelium / Q000473:pathology; D006801:Humans; D018613:Microscopy, Confocal / Q000379:methods; D008875:Middle Aged; D012720:Severity of Illness Index