CLEAR - Anatomy and physiology of the anterior eye

Laura E Downie; Stefan Bandlitz; Jan P G Bergmanson; Jennifer P Craig; Debarun Dutta; Carole Maldonado-Codina; William Ngo; Jaya Sowjanya Siddireddy; James S Wolffsohn

doi:10.1016/j.clae.2021.02.009

CLEAR - Anatomy and physiology of the anterior eye

Cont Lens Anterior Eye. 2021 Apr;44(2):132-156. doi: 10.1016/j.clae.2021.02.009. Epub 2021 Mar 25.

Authors

Laura E Downie¹, Stefan Bandlitz², Jan P G Bergmanson³, Jennifer P Craig⁴, Debarun Dutta⁵, Carole Maldonado-Codina⁶, William Ngo⁷, Jaya Sowjanya Siddireddy⁸, James S Wolffsohn⁹

Affiliations

¹ Department of Optometry and Vision Sciences, The University of Melbourne, Australia. Electronic address: ldownie@unimelb.edu.au.
² Höhere Fachschule für Augenoptik Köln, Cologne School of Optometry, Germany; School of Optometry, Aston University, Birmingham, UK.
³ Texas Eye Research and Technology Center, University of Houston College of Optometry, United States.
⁴ Department of Ophthalmology, New Zealand National Eye Centre, The University of Auckland, New Zealand.
⁵ School of Optometry, Aston University, Birmingham, UK.
⁶ Eurolens Research, Division of Pharmacy and Optometry, Faculty of Biology, Medicine and Health, The University of Manchester, UK.
⁷ Centre for Ocular Research & Education, School of Optometry & Vision Science, University of Waterloo, Waterloo, Canada; Centre for Eye and Vision Research (CEVR), 14W Hong Kong Science Park, Hong Kong.
⁸ School of Optometry and Vision Science, University of New South Wales, Australia.
⁹ School of Optometry, Aston University, Birmingham, UK; Department of Ophthalmology, New Zealand National Eye Centre, The University of Auckland, New Zealand.

PMID: 33775375
DOI: 10.1016/j.clae.2021.02.009

Abstract

A key element of contact lens practice involves clinical evaluation of anterior eye health, including the cornea and limbus, conjunctiva and sclera, eyelids and eyelashes, lacrimal system and tear film. This report reviews the fundamental anatomy and physiology of these structures, including the vascular supply, venous drainage, lymphatic drainage, sensory innervation, physiology and function. This is the foundation for considering the potential interactions with, and effects of, contact lens wear on the anterior eye. This information is not consistently published as academic research and this report provides a synthesis from all available sources. With respect to terminology, the report aims to promote the consistent use of nomenclature in the field, and generally adopts anatomical terms recommended by the Federative Committee for Anatomical Terminology. Techniques for the examination of the ocular surface are also discussed.

Keywords: Blink; Conjunctiva; Contact Lens Evidence-Based Academic Report (CLEAR); Contact lens; Cornea; Eyelid; Meibomian gland; Nerve; Ocular surface; Tear film.

MeSH terms

Conjunctiva
Contact Lenses*
Cornea
Eyelids
Humans
Tears*