Corneal dystrophy

In vivo confocal microscopic image of the corneal endothelium manifesting Fuch's endothelial dystrophy.

The wide phenotypic variability of corneal dystrophies often precludes accurate diagnosis by slit-lamp examination alone, due to indistinguishable clinical characteristics. Histological examination of affected tissue, following corneal transplantation, is often the only method by which a definitive diagnosis can be reached, but such measures are often unjustifiable in mildly-affected cases. In vivo confocal microscopy allows non-invasive visualisation, not only of the corneal cellular components, but also the structures, which may appear as flecks or dots in the corneal stroma on slit-lamp examination. Such detailed examinations performed during the course of clinical progression of corneal dystrophies, together with further histological correlations, may provide greater insight into the pathogenesis of the conditions and enable development of more comprehensive clinicopathological classification systems.