Indian Journal of Ophthalmology

ARTICLES
Year
: 1981  |  Volume : 29  |  Issue : 3  |  Page : 297--300

Goblet cell population in normal and trachomatous eyes


AT Rangwala, V Kalevar 
 M & J Institute of Ophthalmology, Civil Hospital, Ahmedabad, India

Correspondence Address:
A T Rangwala
M & J Institute of Ophthalmology, Civil Hospital, Ahmedabad
India




How to cite this article:
Rangwala A T, Kalevar V. Goblet cell population in normal and trachomatous eyes.Indian J Ophthalmol 1981;29:297-300


How to cite this URL:
Rangwala A T, Kalevar V. Goblet cell population in normal and trachomatous eyes. Indian J Ophthalmol [serial online] 1981 [cited 2024 Mar 29 ];29:297-300
Available from: https://journals.lww.com/ijo/pages/default.aspx/text.asp?1981/29/3/297/30905


Full Text

Goblet cells are chief secretors of mucous. Since patients with trachoma frequently demonstrate clinical signs and symptoms of dry eye and improve remarkably with mucous replacing artificial tears solutions, it is of utmost interest, particularly in our country, to study the system of mucous glands i.e , goblet cells in trachomatous eyes and to compare them with the one found in normal eyes.

 MATERIALS AND METHODS



Conjunctival biopsies were taken either while patient underwent some routine surgical procedure or otherwise after anaesthetizing the conjunctival sac. The site chosen was upper nasal bulbar conjunctiva since goblet cells are found here in considerable density. A. small 3 x 5 mm piece was snipped off with scissors after lifting up with one in two teeth forceps.

These biopsies were processed routinely at our corneal laboratory and slides were prepared from paraffin block. Two stains were used for each specimen. Haemotoxylin Eosin and PAS (Periodic Schiff Stain) with Light green as counter stain. PAS is specific for mucopolysaccharide and stained mucous containing goblet cells dark red.

Ocular micrometry was carried out on Ernst Leitz Wetzlar (W. Germany) binocular microscope using 150 times magnification. The graticule in LE was a square 400 x 400 micron & was subdivided into 25 small squares, each 80 x 80 micron. The scale division in RE piece was 800 micron long, subdivided into smaller divisions of 8 micron.

For counting purpose, always a whole goblet cell within the graticule was included. On PAS staind microslide, the best section was selected and adjusted in such a way that whole epithelial breadth was included. 3 counts were done at 3 different places and average was multiplies by 6.25 to get goblet cell count per sq.mm area.

In all 77 biopsies were studied, 30 (38.94%) obtained from patients who had distinctive clinical signs of trachoma in one or other stage. 47 (61.06%) were obtainedI from patients with no clinical signs of trachoma.

 OBSERVATIONS



Goblet cell population in normal eyes

Although 47 biopsies were from eyes free of trachoma, all these were not considered `normal'. Eyes with distinct symptom of dry eye were excluded and only completely non�symptomatic, non-trachomatous eyes were taken as `normal control'. A total of 28 patients fell into this category.

The [Table 1] below shows average goblet cell population in these eyes.

It is seen that as age advances, population of goblet cell gradually decreases. Starting with an average of 129 cells/sq.mm area in age group of 11 -20 years, it falls to a count of 43 cells/sq.mm for the age group above 60 years.

During this study it was also observed that goblet cells can assume different patterns of arrangement. Although mast of the cells were separately distributed, some biopsies also showed glandular arrangement. Depending upon the goblet cell population in a particular specimen, the goblet cells were to be arranged in a continuous row or-'scantily placed in the anterior epithelial layers [Figure 2][Figure 3]. Most of these cells were nearer to the surface of epithelium, though they were frequently observed at different levels in epithelium itself, even at deepest germinal layer level too. This observation is in agreement with similar reports by Kessing (1968).

Glandular or acinar arrangement of goblet cells was either restricted within epithe�lium itself, frequently showing an opening on surface of epithelium through a narrow neck [Figure 4] or situated in subconjunctival tissue [Figure 5]. The latter were obviously due to section having been cut through subconjuncti�val extension of mucous crypts of goblet cells.

Such a glandular arrangement was seen in 10 biopsies, 7 normal and 3 trachomatous eyes. Age wise distribution and goblet cell count of these normal eye biopsies is given below in [Table 2].

That fact yet remains to be explored whether this mode of arrangement is a normal variation or some other influencing factor uptil now unrevealed, is working at the back stage. Whatever it may be, but it is certainly not the age of the patient, as is evident from above [Table 2].

Goblet cell population in Trachomatous Eyes

By virtue of subconjunctival scarring, trachoma is known to disturb the normal conjunctival histology. Chronic trachomatous involvement of conjunctiva can reduce the goblet cell population causing changes in the biochemistry of tear film and its break-up time.

The following [Table 3] presents average goblet cell population in trachomatous eyes (which includes trachoma Grade- IIIB, healed as well as complicated && degenerate stage) as compared to normal eyes.

 DISCUSSION



Thus it is evident from the tables above that trachomatous eyes show considerably lesser number of goblet cells/sq.mm. as compa�red to the same age group of normal eyes (except in age group above 60). This histologi�cal evidence correlates perfectly well with the frequent clinical observation of dry eye symptom in trachomatous patients.

Extensive subconjunctival scarring as occur in complicated trachoma which has lasted over a long period can be responsible for total destruction of these secretory cells.

The conjunctival epithelium in these cases, as is well known, shows extensive keretinization and when differentially stained with PAS, reveals a total absence of goblet cells [Figure 5].

Parallel to this variation in goblet cell count in normal and trachomatous eyes, size of cell also showed marked changes. Average diameter of goblet cells in normal eyes ranged from 16 to 24 microns. In trachomatous eyes, cells were often smaller, less than 8 micron at many places. Contrary to this, cells in normal eyes showing glandular arrangement were as large as 56 micron diameter.