J Korean Ophthalmol Soc.  2008 Aug;49(8):1215-1219. 10.3341/jkos.2008.49.8.1215.

Visualization of Subconjunctival Lymphatics and Its Significance

• Kim JT
• Kim JH
• Kim JC

• KMID: 2211723
• DOI: http://doi.org/10.3341/jkos.2008.49.8.1215

Abstract

PURPOSE
To observe and characterize subconjunctival lymphatics in patients with subconjunctival hemorrhages.
METHODS
Patients who visited our clinic with subconjunctival hemorrhage resulting from ocular trauma, or subconjunctival injection of gentamicin and betamethasone during a cataract operation, were included in this study. Subconjunctival hemorrhages and subconjunctival lymphatics were observed using slit lamp biomicroscopy.
RESULTS
Apparent dilated lymphatics were found in one patient with subconjunctival hemorrhage after rubbing of the eye; thin lymphatics were found in 10 patients with traumatic subconjunctival hemorrhages; and apparent dilated lymphatics were found in 10 patients after subconjunctival injection. Slit lamp biomicroscopy using a green filter allowed easy visualization of subconjunctival lymphatics.
CONCLUSIONS
Subconjunctival lymphatics, which are not visible in normal ocular conditions, are evident on subconjunctival hemorrhages, especially after subconjunctival drug injection.

Keyword

Conjunctiva; Subconjunctival hemorrhages; Subconjunctival lymphatics

MeSH Terms

Betamethasone
Cataract
Conjunctiva
Gentamicins
Hemorrhage
Humans
Betamethasone
Gentamicins

Figure

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  Figure 1. (A) Sausage-like lymphatic channel filled with hemorrhage are shown: slit lamp finding. (B) slit lamp finding under green filter. (C) nasal aspect of lymphatic channel shows definite annular ring interrupting lymphatic hemorrhage. (D) anatomy of subconjunctival lymphatic channel cited from Gray’s anatomy.10

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  Figure 2. The linear conjunctival lymphatics (white arrow) are shown. (A) 24-year-old male patient-subconjunctival hemorrhage due to eyeball contusion. (B) 36-year-old female patient-subconjunctival hemorrhage due to eyeball contusion. (C, D) 42-year-old male patient-subconjunctival hemorrhage due to eyeball contusion. (A, B, D) Findings under the green illumination.

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  Figure 3. Well visible dilated conjunctival lymphatics (white arrow) and lymphatic cyst (black arrow) are shown. More dilated lymphatics than those in trauma cases are seen. (A, B) 62-year-old female patients who received subconjunctival injection of gentamicin and bethamethasone after phacoemulsification. (C, D) 66-year-old female patients received the same procedure. Slit lamp finding without filter (C) and with green filter (D), respectively.

Reference

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