Confocal microscopy of the cornea

Abstract

This paper provides the clinician and the researcher with an in-depth manual on the use of a scanning-slit confocal light microscope for the clinical examination and investigation of the living human cornea in vivo. The scope of the paper includes a thorough explanation of the principles of various types of confocal microscopes as well as their limitations, a comprehensive review of the development of biomicroscopy of the eye, and a comparison of confocal microscopy and other optical techniques such as optical coherence tomography. The early work of Ridley, Goldmann and others on point illumination in early confocal instruments is described. The main part of the paper describes and illustrates the clinical examination of the living human cornea with the confocal microscope. Figures (many in color) from the normal cornea, the cornea with known parthologies, and the postsurgical cornea are selected for their educational value. Photographs of standard light microscopy of fixed, human corneal sections are compared with confocal maicroscopic images. Where appropriate, slit lamp color photographs are compared with confocal microscopic images. The clinical scanning-slit confocal microscope is an evolving instrument for biomicroscopy of the living eye.