Figure 1.

Images from a normal healthy eye (a–d) and from individuals with follicular trachoma (e–h), trachomatous scarring (i–l), and trichiasis and progressive scarring (m–p). (a), (e), (i), and (m) are photographs of the tarsal conjunctiva showing normal appearance (a), papillary inflammation and follicles (e), bands of trachomatous scarring (i), and extreme trichiasis and corneal opacity (m). (b), (c), (f), (g), (h), (j), (k), and (l) are in vivo confocal microscopy images of the tarsal conjunctiva at various depths (the bar represents 50 μm). A moderate number of inflammatory nuclei are present in the subepithelium of a healthy eye (b), whereas a higher number are present in trachomatous inflammation (f). Follicles can be seen in (g) and (h). The connective tissue of the healthy conjunctiva is amorphous (c), whereas successive grades of trachomatous scarring are seen as a heterogeneous clumpy appearance (j), defined tissue bands that make up <50% of the scan area (k), and defined bands that make up >50% of the scan area (l). (d) and (n–p) are histological images of tissue scarring using polarized light (original magnification ×100). In the healthy conjunctiva, collagen fibers are parallel (arrows) with the surface epithelium (d), whereas progressive disorganization of this appearance is observed in scarring (n–p). Images are kindly provided with permission from Matthew Burton and Victor Hu and are adapted from Hu et al. 2011 [11] and Hu et al. 2013 [12].