Ocular immune system

The ocular immune system protects the eye from infection and regulates healing processes following injuries. The interior of the eye lacks lymph vessels but is highly vascularized, and many immune cells reside in the uvea, including mostly macrophages, dendritic cells, and mast cells. These cells fight off intraocular infections, and intraocular inflammation can manifest as uveitis (including iritis) or retinitis. The cornea of the eye is immunologically a very special tissue. Its constant exposure to the exterior world means that it is vulnerable to a wide range of microorganisms while its moist mucosal surface makes the cornea particularly susceptible to attack. At the same time, its lack of vasculature and relative immune separation from the rest of the body makes immune defense difficult. Lastly, the cornea is a multifunctional tissue. It provides a large part of the eye’s refractive power, meaning it has to maintain remarkable transparency, but must also serve as a barrier to keep pathogens from reaching the rest of the eye, similar to function of the dermis and epidermis in keeping underlying tissues protected. Immune reactions within the cornea come from surrounding vascularized tissues as well as innate immune responsive cells that reside within the cornea.

The most important function of the cornea is to transmit and refract light so as to allow high-resolution images to be produced on the back of the retina. To do this, collagen within the cornea is highly ordered to be 30 nanometers in diameter and placed 60 nanometers apart so as to reduce light scatter. Furthermore, the tissue is not vascularized, and does not contain lymphoid cells or other defense mechanisms, apart from some dendritic cells (DC). Both of these factors necessitate the small number of cells within the cornea. However, this necessitates keeping immune cells at a relative distance, effectively creating a time delay between exposures to a pathogen and mounting of an immune response. Therefore, many immune and protective responses within the cornea, such as moistening and nutrition, come from non-local sources, such as the conjunctiva.

Innate immune responses defend against pathogens and toxin in a non-discriminatory manner. They provide an inherent barrier against corneal infection while also serving as a primary mode of defense that is present from birth. For instance, the orbit and the eyelid can guard against both traumatic events and exterior debris that may contain microorganisms. Other components of the ocular innate immune system include tears, epithelial cells, , corneal nerves, the complement system, and interferons.

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