CYTOMORPHOLOGY OF THE BULBAR CONJUNCTIVAL CELLS IN PATIENTS WITH DRY EYE

Dry eye is among the most common pathological conditions in ophthalmology. The aim of our study was to present possibilites of two different cytological methods for examination of cytomorphology of bulbar conjunctival cells- impression cytology (IC) and combined cytological method for scanning electron microscopy in the diagnosis  of dry eye (ICSEM). A hundred and twenty-two patients of both sexes, in different age groups, were analyzed by clinical method (slit lamp, Schirmer I, TBUT, Rose Bengal) and two cytomorphological methods – IC and ICSEM. In patients with dry eye, squamous metaplasia, inflammation and severe loss of adhesiveness of the epithelium were present. ICSEM gives an advantage in early diagnosis of changes, before the lesion of superficial conjunctival epithelium in patients with dry eye. The phenomenon of metaplasia appears in the epithelium of the bulbar conjunctiva in the absence of manifest dry eye and represents the basis for understanding the increased incidence of this syndrome in older patients with dry eye.