It is important to complete an external eye examination in some patients by viewing the palpebral (or tarsal) conjunctiva which lines the inside of the eyelids.
The conjunctiva in the lower fornix may demonstrate multiple small pale elevations known as follicles, which can be a feature of viral or chlamydia conjunctivitis. The lower lid lining can also be very red and inflamed due to eye drop toxicity (including preservative allergy). Other conditions affecting the lower fornix include mucous retention cysts, pyogenic granulomas and concretions.