Clinical anatomy: cornea and ocular surface

Area of Science:

• Ophthalmology and Vision Science
• Anatomy and Histology
• Immunology

Background:

• The cornea and ocular surface form a critical barrier and refractive medium, maintaining transparency and immune function.
• Environmental stressors challenge this interface, relying on the tear film, epithelium, and stem cells for stability.
• Disruptions can lead to vision impairment and disease vulnerability, necessitating advanced diagnostic and treatment approaches.

Purpose of the Study:

• To review and integrate recent findings on the anatomy and physiology of the cornea and ocular surface.
• To assess the clinical relevance of current knowledge for understanding and treating ocular surface disorders.
• To highlight the importance of a comprehensive anatomical understanding for therapeutic advancements.

Main Methods:

• A targeted literature search was performed using PubMed/MEDLINE and Google Scholar.
• English-language publications from January 2000 to May 2025 were included.
• Keywords covered corneal and ocular surface anatomy, histology, and related structures; manual screening of references was also conducted.

Main Results:

• Eighty-six publications revealed the cornea and ocular surface as an integrated unit essential for vision.
• This unit includes the cornea, conjunctiva, tear film, meibomian glands, goblet cells, and limbal stem cells, providing lubrication and immune defense.
• Disruptions, like in dry eye or stem cell deficiency, cause epithelial breakdown and potential vision loss, reframing ocular surface disease as multifactorial.

Conclusions:

• Corneal and ocular surface components synergistically maintain a stable refractive surface for vision.
• Understanding their coordinated roles in protection, lubrication, and repair is crucial for targeted therapies and improved clinical outcomes.
• Future research should advance regenerative strategies and personalized treatments for complex ocular surface disorders.