Mucus alteration and eye dryness. A possible relationship

From a very early phase we studied 15 patients suffering from a dry-eye condition ant associated to systemic diseases. Conjunctival biopsies were studied in Transmission (TEM) and Scanning (SEM) electron microscopy. Moreover, the lectin-gold cytochemistry at ultrastructural level was applied to investigate the distribution of some glycosidic receptors produced by both the goblet cells and the vesicles belonging to the Second Mucus System (SMS). No evidence of epithelial stratification and only a decrease in the goblet cell population was observed. The SMS vesicles and the superficial cell microvilli did not appear greatly reduced in number. A difference in the mucus composition in terms of content of glycosidic residues was detected in dry-eye patients compared to the normal subjects. The role of the mucus produced by both the goblet cells and the SMS vesicles in debated. A possible correlation between the alteration of the mucus content and the failure of the tear film stability is proposed. On the basis of these data, a new therapeutic approach for eye dryness is suggested.