Pathological Conditions of the Ocular Surface - A Clinical and Confocal Laser-Scanning Microscopy Study

Confocal in vivo laser scanning microscopy is an established technique to visualise morphology of the cornea and conjunctiva, whereby the image interpretation needs experience. We report about changes of the ocular surface in the pathological conditions of infectious, metabolic and traumatic genesis and discuss their relevance. The micromorphology of the corneal epithelium and stroma in respect to pathogens (bacterial, fungal) is discussed. Metabolic disease induces multifaceted corneal alterations which can be visualised and used for assessment of the disease progression. Follow-up microscopic investigations allow for an assessment of the wound healing dynamics and enable a prognosis to be made for corneal recurrence. Taken together, confocal in vivo microscopy allows a non-invasivemicroscopy on the cellular level and thus complements clinical diagnostics.