Conjunctiva, we hardly knew you

As a practical matter, I equate the term vestigial with something that serves no useful function or has no redeeming purpose. In other words, we'd be just as well off, if not better, without it. Good examples include the aforementioned appendix, the ear lobe, and the reality television show "Jersey Shore."

But what about the eye? Does this organ contain any vestigial structures? The question popped into my mind upon reading the abstracts for the second-largest ophthalmology meeting in the country (http://ascrsasoa2010.abstractcentral.com/planner/). Under the category of cosmetic procedures, I came across the interesting title, "Cosmetic conjunctival surgery to treat chronic hyperemic conjunctiva."

Over the past quarter century, as a resident, fellow, and corneal and external disease specialist, I have come to have a certain respect, if not affection, for the conjunctiva. Like other mucosal surfaces, it generates mucus, plays a role in immunity, and seems to play some sort of role in maintaining the health of the cornea and ocular surface.

On the other hand, it can become infected, swell, and become hyperemic; can become afflicted later in life with squamous cell neoplasia; and might play a negative role in certain autoimmune diseases, such as peripheral ulcerative keratitis.