Amudha Vadivu Subramaniyan
BACKGROUND
To outline the technique and interpretation of Conjunctival Impression Cytology (CIC). 20 normal subjects between the age of
20-40 years with normal Schirmer’s basic secretion test (>10 mm) and Tear Breakup Time (TBUT >10 secs) were included in
this study. Subjects with a history of contact lens use, ocular surgery, degenerative corneal disease, autoimmune and metabolic
disease and subjects on systemic or topical medications were excluded from the study.
MATERIALS AND METHODS
The Conjunctival Impression Cytology (CIC) sample was collected from superotemporal quadrant of bulbar conjunctiva using
cellulose acetate filter paper 0.45 μm (millipore), stored and stained with PAS and Hematoxylin stain. The sample so obtained
was then analysed for epithelial cells, goblet cells, mucin spots, mucin strands, mucus debris and other cells, e.g. neutrophils,
mast cells, etc. Goblet cell density was then calculated as number of goblet cells multiplied by 100 number of epithelial cells
and expressed as % per HPF. Squamous metaplasia was observed and graded based on goblet cell density and morphology,
morphological changes of the nucleus and epithelial cells, metachromatic changes of cytoplasm and keratinisation and Nuclearto-
Cytoplasmic Ratio (N/C).
RESULTS
The GCD in the superotemporal quadrant of bulbar conjunctiva ranged from 24.2% to 36.5% with a mean of 30.60%. None of
the eyes showed any squamous metaplasia. The technique of CIC, staining, calculation of goblet cell density and grading of
squamous metaplasia will be discussed.
CONCLUSION
CIC is a simple, rapid, reliable, reproducible, noninvasive and effective technique, which can be used for diagnosis, treatment
and prognosis of ocular surface disorders.
