Visualization of Subconjunctival Lymphatics and Its Significance

Jee Taek Kim; Jae Hoon Kim; Jae Chan Kim

doi:10.3341/jkos.2008.49.8.1215

Journal List > J Korean Ophthalmol Soc > v.49(8) > 1008038

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Kim, Kim, and Kim: Visualization of Subconjunctival Lymphatics and Its Significance

Original Article

J Korean Ophthalmol Soc 2008;49(8):1215-1219.

Published online: 7 September 2008

DOI: https://doi.org/10.3341/jkos.2008.49.8.1215

Visualization of Subconjunctival Lymphatics and Its Significance

Jee Taek Kim, M.D., Jae Hoon Kim, M.D., Jae Chan Kim, M.D., Ph.D.

Department of Ophthalmology, Chung-Ang University College of Medicine, Seoul, Korea

Address reprint requests to Jae Chan Kim, M.D., Ph.D. Department of Ophthalmology, College of Medicine, Chung-Ang University, Yongsan Hospital #65-207 Hangangro-3ga, Yongsan-gu, Seoul 140-757, Korea Tel: 82-2-748-9838, Fax: 82-2-6381-9838, E-mail: jck50ey@kornet.net

Received 14 May 2008 Accepted 11 October 2007

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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.

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Keywords: Conjunctiva, Subconjunctival hemorrhages, Subconjunctival lymphatics

References

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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.

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