Evidence for sympathetic neural influence on human corneal epithelial function

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Abstract
Patients with unilateral Horner's syndrome were studied to determine the influence of sympathetic innervation on the structure and function of the human cornea. There was no difference in total corneal thickness, corneal oxygen uptake rate or corneal touch threshold between the normal and Horner's eyes of these patients. Epithelial thickness, however, was slightly but significantly greater in the Horner's eye than in the normal fellow eye (P < 0.025). When subjected to a hypoxic “Stress Test”, patients with post‐ganglionic lesions showed significantly more epithelial greying and microcystic oedema (P < 0.025 and P < 0.01, respectively) and reported seeing smaller and brighter haloes in the Horner's eye. The cornea of the affected eye of these patients also showed a significantly slower rate of deswelling in the first hour following the “Stress Test” (P < 0.05). These findings suggest that both in the resting state and when the cornea is physiologically challenged, the sympathetic nervous system and in particular, the terminal sympathetic neuron, has a small but significant influence on the human corneal epithelium.

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