Research Projects in Dry Eye Syndrome

Editor(s): Brewitt H. (Hannover) 
Table of Contents
Vol. 45, No. , 2010
Section title: Paper
Brewitt H (ed): Research Projects in Dry Eye Syndrome. Dev Ophthalmol. Basel, Karger, 2010, vol 45, pp 108–122

The Lid Margin Is an Underestimated Structure for Preservation of Ocular Surface Health and Development of Dry Eye Disease

Knop E.a · Korb D.R.b · Blackie C.A.b · Knop N.c
aResearch Laboratory, Department of Ophthalmology CVK, Charité – Universitätsmedizin Berlin, Berlin, Germany; bKorb Associates, Boston, Mass., USA; cDepartment of Cell Biology in Anatomy, Hannover Medical School, Hannover, Germany
email Corresponding Author

PD Dr. Erich Knop, Research Laboratory of the Department of Ophthalmology CVK, Charité – Universitätsmedizin Berlin, Ziegelstrasse 5-9, DE-10117 Berlin (Germany), E-Mail

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Purpose: The structure of the lid margin is insufficiently understood and defined, although it is of obvious importance in ocular surface integrity. Methods: The structure and function of the different zones of the lid margin are explained with a focus on dry eye disease. Results: The posterior lid margin, which is of particular significance for the integrity of the ocular surface, includes the meibomian glands that open within the cornified epidermis. Their obstructive dysfunction is a main cause of dry eye disease. The orifice is followed by the mucocutaneous junction, which extends from the abrupt termination of the epidermis to the crest of the inner lid border. The physiological vital stainable line of Marx represents its surface, and can be used e.g. as a diagnostic tool for the location and functionality of the meibomian gland orifices and lacrimal puncta. The marginal conjunctiva starts at the crest of the inner lid border and forms a thickened epithelial cushion. This is the point closest to the globe, and represents the zone that wipes the bulbar surface and distributes the thin preocular tear film. It is hence termed the ‘lid wiper’ and pathological alterations that result in a vital staining are a sensitive early indicator of dry eye disease. Conclusions: The margin of the eyelid is an important but currently underestimated structure in the maintenance of the preocular tear film and of the utmost importance for the preservation of ocular surface integrity and in the development of dry eye disease.

© 2010 S. Karger AG, Basel

Article / Publication Details

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Published online: 5/18/2010
Cover Date: 2010

Number of Print Pages: 15
Number of Figures: 0
Number of Tables: 0

ISBN: 978-3-8055-9418-9 (Print)
eISBN: 978-3-8055-9419-6 (Online)

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