title: Confocal microscopy of the bulbar conjunctiva in contact lens wear.
abstract: OBJECTIVE
  The aim of this study was to investigate the capabilities of laser scanning confocal microscopy (LSCM) for undertaking qualitative and quantitative investigations of the response of the bulbar conjunctiva to contact lens wear.
  
  
  METHODS
  LSCM was used to observe and measure morphological characteristics of the bulbar conjunctiva of 11 asymptomatic soft contact lens wearers and 11 healthy volunteer subjects (controls).
  
  
  RESULTS
  The appearance of the bulbar conjunctiva is consistent with known histology of this tissue based on light and electron microscopy. The thickness of the bulbar conjunctival epithelium of lens wearers (30.9 +/- 1.1 microm) was less than that of controls (32.9 +/- 1.1 microm) (P < 0.0001). Superficial and basal bulbar conjunctival epithelial cell densities in contact lens wearers were 91% and 79% higher, respectively, than that in controls (P < 0.0001). No difference was observed in goblet and Langerhans cell density between lens wearers and controls. Conjunctival microcysts were observed in greater numbers, and were larger in size, in lens wearers compared with controls.
  
  
  CONCLUSIONS
  The effects of contact lens wear on the human bulbar conjunctiva can be investigated effectively at a cellular level using LSCM. The observations in this study suggest that contact lens wear can induce changes in the bulbar conjunctiva such as epithelial thinning and accelerated formation and enlargement of microcysts, increased epithelial cell density, but has no impact on goblet or Langerhans cell density.
authors.affiliation: Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia. n.efron@qut.edu.au
authors.forename: Nathan
authors.initials: N
authors.lastname: Efron
authors.forename: Munira
authors.initials: M
authors.lastname: Al-Dossari
authors.forename: Nicola
authors.initials: N
authors.lastname: Pritchard
mesh_terms: D000328:Adult; D002452:Cell Count; D003228:Conjunctiva / Q000473:pathology*; D003229:Conjunctival Diseases / Q000175:diagnosis* / Q000209:etiology; D003261:Contact Lenses / Q000009:adverse effects*; D003560:Cysts / Q000175:diagnosis* / Q000209:etiology; D004847:Epithelial Cells / Q000473:pathology*; D005260:Female; D020397:Goblet Cells / Q000473:pathology; D006801:Humans; D007801:Langerhans Cells / Q000473:pathology; D008297:Male; D018613:Microscopy, Confocal; D010865:Pilot Projects