• Biopsy specimens from the upper tarsal conjunctivae of ten patients with clinically evident contact-lens-associated giant papillary conjunctivitis (GPC) and eight asymptomatic contact lens wearers without clinically evident conjunctival changes were compared by light and transmission electron microscopy to determine the contribution of nongoblet epithelial cells to increased mucus. A control group consisted of five subjects who had never worn contact lenses. The apical cytoplasm of superficial nongoblet epithelial cells in specimens from all groups showed single-membrane-limited vesicular inclusions that stained metachromatically with toluidine blue and were positive with PAS staining, which indicated mucoprotein content. Some vesicles appeared to discharge their contents into the conjunctival sac. More vesicles were found in the GPC subjects and the asymptomatic contact lens wearers than in the normal subjects. These observations, coupled with the sign of increased or excessive mucus discharge in GPC subjects and in asymptomatic lens wearers, support the premise that the superficial layers of nongoblet conjunctival epithelial cells can contribute to an increase in mucus production.
Greiner JV, Kenyon KR, Henriquez AS, Korb DR, Weidman TA, Allansmith MR. Mucus Secretory Vesicles in Conjunctival Epithelial Cells of Wearers of Contact Lenses. Arch Ophthalmol. 1980;98(10):1843-1846. doi:10.1001/archopht.1980.01020040695020