What is the difference between bulbar and palpebral conjunctiva?

The bulbar conjunctiva covers the anterior part of the sclera (the white of the eye). It does not cover the cornea. The palpebral conjunctiva covers the inner surface of the upper and lower eyelids. The bulbar and palpebral conjunctiva are both continuous, making it impossible to lose a contact lens behind your eye.

How do you assess bulbar and palpebral conjunctiva?

The superior and inferior portions of the bulbar conjunctiva may be assessed by gently holding the patient’s eyelid open while the patient looks up or down. The palpebral conjunctiva and fornices may be more difficult to assess but may be assessed using a small cotton swab to invert the lid.

What is conjunctival concretion?

Conjunctival concretions are small, typically multiple, yellow-white lesions commonly found on palpebral conjunctiva of elderly individuals and those with chronic inflammation. They are thought to be widespread and typically asymptomatic, occurring in 40-50% of studied populations.

How are conjunctival concretions treated?

If concretions are causing symptoms, the optometrist may offer to remove them. After numbing the eye surface with an anaesthetic drop, the concretions can usually be teased out with the tip of a hypodermic needle. Rarely, antibiotic drops may be prescribed.

What is the difference between conjunctiva and sclera?

The conjunctiva is the membrane that lines the eyelid and loops back to cover the sclera (the tough white fiber layer covering the eye), right up to the edge of the cornea (the clear layer in front of the iris and pupil—see Structure and Function of the Eyes.

How do you inspect bulbar conjunctiva?

The conjunctiva lining the inner eyelid of the lower lid may be inspected by gently pulling down the lid with a finger. The conjunctiva lining the upper lid can only be observed by everting the upper lid as shown in Figure 114.1. The lacrimal apparatus is checked by observing for excess dryness or tearing.

What are conjunctival concretions made of?

The primary components of conjunctival concretions are degenerating epithelial cells and inspissated secretions from conjunctival glands. Following inflammation, the debris get trapped in sub-conjunctival depressions (Henle glands), and they often undergo calcification.

How do you treat concretion?

Most concretions remain asymptomatic and do not need a specific treatment. If the patient is symptomatic, the specific concretions may be removed. Method of removal: Proparacaine hydrochloride 0.5% drops are instilled, and the lid is everted to expose the palpebral conjunctival surface.

Where is the palpebral fissure?

Definitions. Palpebral fissure length: distance between the inner and outer canthi of the eye; the actual palpebral fissure encompasses the exposed area between the top and bottom eyelids. The adult palpebral fissure is typically about 3 cm horizontally and 0.8 to 1.1 cm vertically.

What is bulbar in eye?

(BUL-bar kun-JUNK-tih-VY-tis) A condition in which the thin layer of tissue that covers the sclera (the white part of the eye) becomes inflamed. The cause is usually not known, but it may occur with certain inflammatory conditions, such as lupus and rheumatoid arthritis.

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