Goblet cell densities were determined in the eyes of normal subjects and in the eyes of patients with various ocular surface diseases using an impression cytological technique. For normal eyes goblet cell densities on the interpalpebral bulbar and inferior palpebral ocular surfaces were 443 (+/- 266 [+/- SD]) and 1,972 (+/- 862) cells millimeter, per square, respectively. All patients in the ocular surface disease groups had decreased goblet cell densities compared with subjects with normal eyes. Compared with normal eyes, eyes with keratoconjunctivitis sicca (KCS) demonstrated a 17% greater goblet cell loss on the interpalpebral bulbar compared with the inferior palpebral ocular surface, while eyes with blepharitis and secondary KCS demonstrated an 8% greater loss on the inferior palpebral surface compared with the interpalpebral bulbar ocular surface. Eyes with cicatricial ocular pemphigoid and Stevens-Johnson syndrome demonstrated greater than 95% goblet cell loss on both the interpalpebral bulbar and inferior palpebral ocular surfaces compared with normal eyes.