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Conjunctival impression cytology

Eye Care estimated about CNY 300-600

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Description

A diagnostic procedure where a sterile filter paper or membrane is pressed onto the conjunctiva to collect superficial epithelial cells for microscopic examination of inflammatory, infectious, or neoplastic conditions.

Main Uses

Primary clinical uses include: (1) diagnosing and monitoring ocular surface disorders (e.g., dry eye, allergic and infectious conjunctivitis), (2) evaluating goblet cell density and epithelial differentiation in chronic inflammatory or autoimmune conditions, (3) detecting early dysplastic or neoplastic changes (e.g., conjunctival intraepithelial neoplasia), (4) assessing treatment response (e.g., after immunomodulatory therapy or vitamin A supplementation), and (5) differentiating between infectious, allergic, and autoimmune etiologies when clinical presentation is ambiguous.

Normal Range

No universal quantitative 'normal range' exists for conjunctival impression cytology, as it is a qualitative histopathological assessment. Normal findings include: (1) stratified non-keratinized squamous epithelium with intact surface cells, (2) absence of goblet cells in the cornea and limbus (present only in conjunctiva), (3) <5% inflammatory cells (lymphocytes, neutrophils) per high-power field (HPF), (4) no dysplastic or malignant cells, and (5) preserved cellular polarity and minimal cytoplasmic vacuolization. Goblet cell density in healthy bulbar conjunctiva typically ranges from 20–100 cells/mm².

Low Values - Possible Causes

1. Severe dry eye syndrome (e.g., Sjögren’s syndrome), 2. Chronic allergic conjunctivitis with goblet cell loss, 3. Vitamin A deficiency (causing squamous metaplasia and goblet cell depletion), 4. Long-term topical corticosteroid or antiviral (e.g., ganciclovir) use, 5. Ocular surface burns (chemical or thermal) leading to epithelial atrophy.

High Values - Possible Causes

1. Allergic conjunctivitis (elevated eosinophils and activated lymphocytes), 2. Infectious conjunctivitis (increased neutrophils in bacterial, lymphocytes in viral), 3. Ocular surface inflammation in autoimmune diseases (e.g., mucous membrane pemphigoid, graft-versus-host disease), 4. Early-stage squamous metaplasia with reactive epithelial hyperplasia, 5. Pre-malignant or malignant lesions (e.g., conjunctival intraepithelial neoplasia — increased nuclear/cytoplasmic ratio, pleomorphism, mitotic figures).

conjunctival impression cytology ocular surface disease goblet cell density

estimated about CNY 300-600