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THE EYES AND EB
Ms Gillian SIM  Ophthalmic Nurse Specialist
Mr Malcolm Kerr-Muir  Consultant Ophthalmologist

Eyelids

The eyelids serve to protect the delicate structures of the eye. They are made up of skin, muscle and fibrous tissue. The skin of the eyelids is amongst the thinnest anywhere on the body.

The skin of the eyelids joins the conjunctiva at the lid margins, which also contain the Meibomian glands for the tear film, and the eyelashes. At the inner aspect of the upper and lower lid margins (towards the nose), there are small ducts, which drain away excess tears into the back of the nose.

The eyelids close over the eye (blinking) many times per minute, but can also be closed voluntarily. Blinking aids the flow of tears across the eye, and the lids can be closed to form an added protective layer at times of potential trauma. The eyelids are closed over the eye at night to help reduce the evaporation of tears.

Disruption of the eyelid structures can result in problems with the tearfilms’ efficiency/production, and can cause continued irritation to the eye itself.

Conjunctiva

The conjunctiva is the thin, transparent mucous membrane covering the posterior (back) surface of the lids and the anterior (front) surface of the eye. It contains the glands and cells necessary for the production of tears. It also acts as a protective layer of the eye. It is a delicate layer, easily traumatised, and inflamed (conjunctivitis).

Cornea

The cornea is a transparent structure, which can be compared in size and form to the crystal of a small wristwatch. It is composed of five different layers and is approximately 0.5mm in thickness. The surface layer of epithelium is very delicate and can be disturbed very easily, although healing is rapid (often a new layer of cells is apparent within 24 hours of injury).

Its functions are to provide a barrier to prevent entrance of infections into the eye, and provide a ‘window’ through which the light rays pass.

The cornea contains many pain fibers, and therefore any disruption to the tissues causes intense pain, which continues until the structure has healed.

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