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Conjunctiva
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== Structure == The conjunctiva is typically divided into three parts: {| class="wikitable" |- ! Part ! Area |- | 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.<ref>{{cite journal | vauthors = Efron N, Al-Dossari M, Pritchard N | title = In vivo confocal microscopy of the bulbar conjunctiva | journal = Clinical & Experimental Ophthalmology | volume = 37 | issue = 4 | pages = 335–44 | date = May 2009 | pmid = 19594558 | doi = 10.1111/j.1442-9071.2009.02065.x | s2cid = 35398240 }}</ref> |- | Fornix conjunctiva | Forms the junction between the bulbar and palpebral conjunctivas: It is loose and flexible, allowing the free movement of the lids and eyeball.<ref>Eye, human Encyclopædia Britannica</ref> |} ===Blood supply=== Blood to the bulbar conjunctiva is primarily derived from the ophthalmic artery. The blood supply to the palpebral conjunctiva (the eyelid) is derived from the [[external carotid artery]]. However, the circulations of the bulbar conjunctiva and palpebral conjunctiva are linked, so both bulbar conjunctival and palpebral conjunctival vessels are supplied by both the ophthalmic artery and the external carotid artery, to varying extents.<ref name=":6">{{cite journal | vauthors = Pavlou AT, Wolff HG | title = The bulbar conjunctival vessels in occlusion of the internal carotid artery | journal = A.M.A. Archives of Internal Medicine | volume = 104 | issue = 1 | pages = 53–60 | date = July 1959 | pmid = 13660526 | doi = 10.1001/archinte.1959.00270070055007 }}</ref> ===Nerve supply=== Sensory innervation of the conjunctiva is divided into four parts:<ref>{{cite web|url=http://www.nda.ox.ac.uk/wfsa/html/u06/u06_b06.htm |title=Table 1: Summary of sensory nerve supply |access-date=July 31, 2016 |url-status=dead |archive-url=https://web.archive.org/web/20130214055618/http://www.nda.ox.ac.uk/wfsa/html/u06/u06_b06.htm |archive-date=February 14, 2013 }}</ref> {| class="wikitable" |- ! Area ! Nerve |- | Superior | * [[Supraorbital nerve]] * [[Supratrochlear nerve]] * [[Infratrochlear nerve]] |- | Inferior | [[Infraorbital nerve]] |- | Lateral | [[Lacrimal nerve]] (with contribution from [[zygomaticofacial nerve]]) |- | Circumcorneal | [[Long ciliary nerves]] |} ===Microanatomy=== The conjunctiva consists of unkeratinized, both stratified squamous and stratified columnar epithelium, with interspersed [[goblet cells]].<ref name=Cecil>{{cite book| vauthors = Goldman L |title=Goldman's Cecil Medicine|year=2012|url=https://archive.org/details/goldmanscecilmed00mdle|url-access=limited|publisher=Elsevier Saunders|location=Philadelphia|isbn=978-1437727883|page=[https://archive.org/details/goldmanscecilmed00mdle/page/n2974 2426]|edition=24th}}</ref> The epithelial layer contains blood vessels, fibrous tissue, and lymphatic channels.<ref name=Cecil /> [[Accessory lacrimal glands]] in the conjunctiva constantly produce the aqueous portion of [[tears]].<ref name=Cecil /> Additional cells present in the conjunctival epithelium include [[melanocytes]], [[Lymphocyte|T and B cell lymphocytes]].<ref name=Cecil />
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