Clinical and diagnostic use of in vivo confocal microscopy in patients with corneal disease

Ophthalmology. 1993 Oct;100(10):1444-54. doi: 10.1016/s0161-6420(93)31457-0.


Background: The purpose of this article is to introduce the practicing ophthalmologist to the optical principles and images produced by a tandem scanning confocal microscope (recently approved by the Food and Drug Administration for general clinical use). The tandem scanning confocal microscope allows real-time viewing of structures in the living cornea at the cellular level in four dimensions (x, y, z, and time).

Methods: Nine patients (2 males, 7 females), ranging in age from 7 to 52 years, were examined. Images were recorded on super VHS videotape, digitized and processed on a computer workstation, and photographed for presentation.

Results: Two-dimensional (x, y) 400 x 400-microns images (9-microns z-axis thickness) are presented for normal corneal structures and for the clinical conditions of herpetic keratitis, wound healing after myopic excimer ablation, Acanthamoeba infection, corneal dystrophies (granular, Reis-Buckler), contact lens abrasion, and the irido-corneal endothelial syndrome.

Conclusion: Clinical confocal microscopy has the unique potential of providing noninvasive assessment of corneal injury and disease at the cellular level that is not available currently from other technologies.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Acanthamoeba Keratitis / pathology
  • Adolescent
  • Adult
  • Animals
  • Child
  • Cornea / cytology
  • Cornea / pathology*
  • Corneal Diseases / diagnosis
  • Corneal Diseases / etiology
  • Corneal Diseases / pathology*
  • Corneal Injuries
  • Female
  • Humans
  • Image Processing, Computer-Assisted
  • Keratitis, Herpetic / pathology
  • Male
  • Microscopy* / instrumentation
  • Microscopy* / methods
  • Middle Aged
  • Myopia / pathology
  • Myopia / surgery
  • Swine