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PubMed1997

Ex vivo phosphorus magnetic resonance spectroscopy on eye bank corneas and corneal metabolic health.

BACKGROUND: Since a potential exists for untoward effects on the cornea from the high magnetic fields and radio-frequency energies, and the further manipulation required for phosphorus-31 magnetic resonance spectroscopy (31P-MRS), we determined the effects of this technology on tissues using paired human corneas (n = 4) meeting criteria acceptable for transplantation. METHODS: Slit-lamp biomicroscopy, pachometry, specular microscopy, and redux fluorophotometry were performed on all corneas. One cornea of each pair was examined (< 30 min) by 31P-MRS. Following 31P-MRS, slit-lamp biomicroscopy, pachometry, and redox fluorophotometry were again performed. RESULTS: Data tabulated included the 31P energy modulus (1.37 +/- 0.28), the ATP/Pi (2.92 +/- 0.59) and SP/Pi (0.76 +/- 0.04) ratios, and the intracorneal pH (7.24 +/- 0.09). CONCLUSION: Since there were no significant differences in slit-lamp biomicroscopy, endothelial density and morphometry, cell counts, and pachometric and redox fluorophotometric measurements between corneas of each pair before and after 31P-MRS analysis, it was concluded that there was no detectable metabolic damage secondary to such analysis. This study suggests that MRS analysis of human eye-bank tissues does not damage the cornea metabolically and may provide a practical evaluation of the health of the cornea at the biochemical level.

Adenosine Triphosphate↗
PubMed1999

Molecular confirmation of carriers for Lowe syndrome.

OBJECTIVE: To determine the sensitivity and specificity of ocular examination for the carrier state of Lowe syndrome in females known to be either carriers or noncarriers by direct DNA diagnosis. DESIGN: Nonrandomized cohort study. PARTICIPANTS: Thirty-one females at risk for carrying Lowe syndrome in 3 families. METHODS: Slit-lamp biomicroscopy after pupillary dilation was performed by a single observer (RAL) who was masked as to carrier status as determined by allele-specific detection of mutations in genomic DNA. RESULTS: Carrier assessment predetermined by slit-lamp biomicroscopic examination yielded only one false-negative in a young girl 5 years of age and no false-positives among 31 female members examined. CONCLUSIONS: Slit-lamp examination is a highly accurate and sensitive test for carrier detection in Lowe syndrome, particularly in women of reproductive age.

Adolescent↗
PubMed2004

Comparison of the clinical diagnosis of diabetic macular edema with diagnosis by optical coherence tomography.

PURPOSE: To compare the diagnosis of diabetic macular edema (DME) by stereoscopic slit-lamp biomicroscopic examination of the fundus with a 78-diopter noncontact lens with diagnosis by optical coherence tomography (OCT). DESIGN: Prospective, double-masked, noninterventional diagnostic study. METHODS: Analysis of slit-lamp biomicroscopic findings compared with OCT measurements. PARTICIPANTS: Patients with DME from a private retina practice. MAIN OUTCOME MEASURES: Presence or absence of macular thickening. RESULTS: The reference range for this clinic was comparable to reference ranges published from other clinics. The clinical detection of DME was less than detection by OCT. Chance-corrected agreements (kappa statistic) of the 2 methods were 0.63 for the foveal zone and 0.36 to 0.42 for the 4 parafoveal zones. The errors committed in clinical examination were primarily of the type in which clinical examination did not detect DME but OCT did (58%-90%) for the 5 zones analyzed. CONCLUSIONS: Reference ranges for OCT seem to be similar for different clinical settings, suggesting the usefulness of OCT in multicenter studies. The current standard of care for DME detection, stereoscopic slit-lamp examination of the fundus, is less sensitive than OCT for detection of DME. Because the principal therapy for DME, focal laser photocoagulation, is mainly sight preserving and not sight restoring, the wider use of OCT may beneficially impact visual disability from DME.

Diabetic Retinopathy↗
PubMed1995

Illustration of the stages of idiopathic macular holes by laser biomicroscopy.

BACKGROUND: The determination of the developmental stage of macular holes is difficult to assess clinically. This may be the reason for the conflicting reports on the risk of vision loss in patients with macular holes and on the value of prophylactic surgery. We have developed a new method, laser biomicroscopy, which provides visualization and photographic record of vitreoretinal structures at the macula. OBJECTIVE: To test the applicability of this method to the identification of macular holes stages. METHODS: Laser biomicroscopy and slit-lamp biomicroscopy were used to examine 18 patients with macular holes, identify the lesions, and classify them according to the various stages of development of idiopathic macular holes as proposed by Gass. RESULTS: Reflections considered to originate from the hyaloid membrane were observed more frequently by laser biomicroscopy than by conventional slit-lamp biomicroscopy. Two fellow eyes were diagnosed by laser biomicroscopy as having stage 1 lesions while slit-lamp biomicroscopy failed to yield a clear diagnosis. In four eyes with stage 3 holes the vitreoretinal separation was apparent only on laser biomicroscopy. Four cases were selected to illustrate the laser biomicroscopic findings in the different stages of macular hole development. CONCLUSIONS: The ease of visualization of the macular lesions with laser biomicroscopy may facilitate the evaluation of the early stages of macular holes and reduce the incidence of misdiagnosis. Furthermore, photographs obtained by laser biomicroscopy may be a useful tool in studies of early stages of macular holes.

Aged↗
PubMed1996

[A specular microscopic study on irradiated rabbit corneas--report I. Early injury of the cornea].

To evaluate the effects of ionizing radiation on the cornea, one eye of healthy mature albino rabbits (n = 5) was irradiated with 20 Gy of X-rays (250 kV, 12 mA). Corneal observation was done with a slit-lamp biomicroscope and a specular microscope before irradiation, and follow-up observations were done at one week and 4 weeks after irradiation. Specular microscopic photographs were analyzed with a digitizer. Although slit-lamp biomicroscopy did not show any abnormal findings in the cornea, specular microscopy revealed a significant enlargement of the mean cell area of the superficial corneal epithelium at 4 weeks after irradiation. There were no significant changes in the corneal endothelium during this study. These results strongly suggest that high doses of X-ray irradiation could induce corneal epithelial injury at the early phase, even when by slit-lamp biomicroscopy shows no abnormal findings in the cornea.

Animals↗
PubMed2003

Optical coherence tomography in malignant glaucoma following filtration surgery.

AIM: To assess the value of slit lamp adapted optical coherence tomography (OCT) for the management of malignant glaucoma following filtration surgery. METHODS: Two patients (three eyes) developed malignant glaucoma following filtration surgery for primary open angle glaucoma (POAG). With slit lamp adapted OCT it was possible to image non-invasively the anterior chamber angle structures during the malignant glaucoma episode, and after pars plana vitrectomy (PPV) with anterior chamber reformation. RESULTS: OCT revealed in both patients a markedly decreased anterior chamber angle with extreme shallowing of the anterior chamber depth during the acute malignant glaucoma phase. This critical closure of the anterior chamber angle resolved after PPV and deepening of the anterior chamber with viscoelastic. After PPV the quantitative values of the anterior chamber angle (ACA) and the anterior chamber opening distance (AOD) increased from 0 to an ACA of 35 degrees (SD 14 degrees ) and an AOD of 426 (SD 162) micro m. CONCLUSIONS: Non-contact slit lamp adapted OCT was helpful to evaluate the anterior chamber structures in malignant glaucoma, and thus could improve management of this serious clinical disorder.

Aged↗
PubMed2003

In vivo confocal microscopy in the patients with cornea farinata.

PURPOSE: To report in vivo corneal confocal microscopic findings of patients with cornea farinata. PATIENTS AND METHODS: Two unrelated patients, a 47-year-old man and a 77-year-old woman, with cornea farinata were studied. Examination with a confocal microscope was performed in addition to routine slit-lamp biomicroscopy. RESULTS: In both cases, slit-lamp biomicroscopy showed numerous small, faint opacities in the deep stroma in both eyes. Using confocal microscopy, highly reflective small particles were observed in the cytoplasm of keratocytes in the deep stroma adjacent to the corneal endothelial layer. No abnormalities could be detected in the epithelial layer, in the mid-stromal layer, at the level of Descemet's membrane, and in the endothelial layer. CONCLUSIONS: In vivo corneal confocal microscopy is useful for observing stromal abnormalities in cornea farinata. Further investigation of posterior stromal opacities using confocal microscopy may be useful to understand and differentiate various corneal conditions involving primarily deep stromal layers.

Aged↗
PubMed1998

Quantitative analysis of foveal retinal thickness in diabetic retinopathy with the scanning retinal thickness analyzer.

PURPOSE: This study sought to measure foveal retinal thickness in patients with diabetic retinopathy and to investigate the relationship between foveal thickness and visual acuity, biomicroscopic findings, and angiographic features. METHODS: A commercial scanning retinal thickness analyzer was used to measure retinal thickness. A laser slit was projected onto the retina and scanned in 400 milliseconds across the central area of the fundus. The image where the laser slit intersects with the retina was digitally recorded and analyzed. Retinal thickness was measured in 35 patients (35 eyes; patient age, 57 +/- 13 years) with diabetic retinopathy. Patients also were examined by fluorescein angiography and slit-lamp biomicroscopy to detect foveal thickening. RESULTS: Linear regression analysis indicated a significant correlation between foveal thickness and visual acuity (adjusted R2 = 0.72, P < 0.001). Foveal thickness was abnormal in 6 (100%) of 6 eyes in which foveal thickening was detected with slit-lamp biomicroscopy. Foveal thickness also was abnormal in 9 (31%) of 29 eyes that appeared normal by biomicroscopic examination. Foveal thickness was 136 +/- 65 microns in 7 eyes without leakage, 175 +/- 35 microns in 13 eyes with questionable leakage, and 291 +/- 120 microns in 7 eyes with definite leakage (P = 0.0075). CONCLUSIONS: Retinal thickness analysis is shown to be more sensitive than slit-lamp biomicroscopy for detecting small changes in retinal thickness. Retinal thickness analysis may prove to be a useful, noninvasive modality for the development or regression of macular edema.

Adult↗
PubMed1998

[Morphometry of the optic disc in Togolese patients with glaucoma or suspected glaucoma. Preliminary study].

PURPOSE: The aim of this study was to measure morphometric parameters of the optic disc in Togolese glaucoma patients and suspects by the mean of the millimetric scale of the slit lamp and the Goldmann contact lens. MATERIAL AND METHOD: We selected 202 patients (393 eyes) with a mean age of 36.69 years +/- 15.33 (standard deviation); they were divided into 2 subgroups A (162 glaucomatous) and B (40 glaucoma suspects); direct reading of the slit lamp millimetric scale and the Goldmann contact lens was used. RESULTS: In the group A, the optic disc vertical diameter was 1.792 +/- 0.21 mm; the horizontal diameter was 1.701 +/- 0.198 mm. In the group B, vertical disc diameter was 1.700 +/- 0.262 mm; the horizontal one was 1.662 +/- 0.190 mm. The vertical cup disc diameter was 1.147 +/- 0.274 mm in the group A and 0.708 mm +/- 0.274 mm in the group B. The neuroretinal area was 1.360 +/- 0.524 mm2 in group A and 1.786 +/- 0.467 mm2 in group B. CONCLUSION: This study using millimetric scale of the slit lamp and the three mirrors Goldmann contact lens was easy, simple and useful clinically. It could be helpful in conducting quantitative studies in countries with low resources because this method is costless compared with others.

Adolescent↗
PubMed1994

Corneal virulence of Staphylococcus aureus: roles of alpha-toxin and protein A in pathogenesis.

Staphylococcus aureus produces a variety of proteins, including alpha-toxin and protein A, that could contribute to corneal tissue damage during keratitis. We examined corneal infections produced by intrastromal injection of four S. aureus strains--three isogenic mutants, one lacking alpha-toxin (Hly- Spa+), one lacking protein A (Hly+ Spa-), and one lacking both alpha-toxin and protein A (Hly- Spa-), and the wild type (Hly+ Spa+)--in a rabbit model of experimental keratitis. Rabbit corneas were injected intrastromally with 100 CFU of one of the four strains, and the eyes were examined by slit lamp biomicroscopy over a 25-h period. Corneal homogenates were used for determination of CFU and neutrophil myeloperoxidase activity at 5-h intervals. All strains had the same logarithmic growth curve from 0 to 10 h postinfection, after which CFU remained constant at 10(7) CFU per cornea. By 15 h postinfection, slit lamp examination scores were significantly higher for eyes infected with Hly+ strains than for Hly(-)-infected eyes. At this time, distinct epithelial erosions were seen in Hly(+)-infected eyes but not in Hly(-)-infected eyes. Myeloperoxidase activity was significantly greater for Hly(+)-infected corneas than for Hly(-)-infected corneas at both 20 and 25 h postinfection. Spa(+)- and Spa(-)-infected eyes showed no differences in slit lamp examination scores or myeloperoxidase activities. These results suggest that alpha-toxin, but not protein A, is a major virulence factor in staphylococcal keratitis, mediating the destruction of corneal tissue in eyes infected with this bacterial pathogen.

Animals↗
PubMed2001

Glutathione peroxidase-1 deficiency leads to increased nuclear light scattering, membrane damage, and cataract formation in gene-knockout mice.

PURPOSE: Previous in vitro studies with transgenic and gene-knockout mice have shown that lenses with elevated levels of glutathione peroxidase (GPX)-1 activity are able to resist the cytotoxic effect of H(2)O(2), compared with normal lenses and lenses from GPX-1-deficient animals. The purpose of this study was to investigate the functional role of this enzyme in antioxidant mechanisms of lens in vivo by comparing lens changes of gene-knockout mice with age-matched control animals. METHODS: In vivo lens changes were monitored by slit lamp biomicroscopy, and enucleated lenses were examined under a stereomicroscope in gene-knockout animals and age-matched control animals ranging in age from 3 weeks to 18 months. Transmission (TEM) and confocal microscopy were performed on different regions of lenses after the mice were killed at various times. RESULTS: Slit lamp images showed an increase in nuclear light scattering (NLS) in gene-knockout mice compared with control animals. TEM revealed changes in the nucleus as early as 3 weeks of age by the appearance of waviness of fiber membranes. With increasing age, there was greater distortion of fiber membranes and distension of interfiber space at the apex of fiber cells compared with control mice. The changes in nuclear fiber membranes were even more dramatic, as observed by confocal microscopy, which was performed on thicker sections. In contrast to the changes in the lens nucleus, the morphology of the epithelium and superficial cortex remained unchanged in knockout animals during the same experimental period, consistent with slit lamp observations. Stereomicroscopy of ex vivo lenses demonstrated a significant increase in opacification in gene-knockout mice relative to control animals of the same age. This effect became evident in mice aged 5 to 9.9 months and persisted thereafter in older animals, resulting in mature cataracts after 15 months. CONCLUSIONS: The results demonstrate the critical role of GPX-1 in antioxidant defense mechanisms of the lens nucleus. The increased NLS appears to be associated with damage to fiber membranes in the nucleus, which is particularly susceptible to oxidative challenge because of the deficiency of GPX-1. It is suggested that the lens membrane changes in the knockout animals may be due to the formation of lipid peroxides, which serve as substrates for GPX-1. Cataract development in gene-knockout mice appeared to progress from focal opacities, apparent at an earlier age, to lamellar cataracts between 6 and 10 months, and finally to complete opacification in animals older than 15 months. This is the first reported phenotype in GPX-1-knockout mice.

Animals↗
PubMed2006

Comparison of toxicological profiles of benzalkonium chloride and polyquaternium-1: an experimental study.

PURPOSE: The aim of this study was to compare, in vivo on a rat model, two different preservatives- benzalkonium chloride (BAC) and polyquaternium-1 (PQ-1)-using new experimental approaches. METHODS: Thirty (30) eyes of 15 male Lewis rats were used in this study. Rats were randomly divided into five groups instilled twice a day for 11 days with eye drops containing different concentrations of preservatives, 0.1% BAC, 0.5% BAC, 0.1% PQ-1, 0.5% PQ-1, and balanced salt solution (BSS) as a control. The ocular surface toxicity of these two preservatives was investigated using new in vivo experimental approaches. Slit-lamp examination, the fluorescein test, the red phenol test, impression cytology, and in vivo corneal confocal microscopy were used to evaluate the rat ocular surface after preservative instillation. Histology sections and immunohistochemistry were also examined to confirm these results. RESULTS: Compared to PQ-1, BAC consistently and dramatically altered the corneoconjunctival surface as evaluated by slit-lamp examination, the fluorescein test, impression cytology, in vivo confocal microscopy, and histology. The 0.5% BAC solution also significantly decreased tear production compared to the control. Although 0.5% PQ-1 significantly decreased goblet cell density in comparison to the control, and some abnormalities were observed with in vivo confocal microscopy, no statistically significant differences were observed between these two groups using the tear production test, slit-lamp and fluorescein evaluation, or histology. CONCLUSION: Using an acute rat model of ocular toxicity by comparing preservatives at high concentrations, we demonstrated in vivo that high doses of PQ-1 were much less toxic than BAC. In vivo confocal microscopy and impression cytology are new promising experimental approaches to studying the rat corneoconjunctival surface, particularly in the field of ocular surface toxicity.

Animals↗
PubMed1984

Ultrastructural appearances of a lens with marked polychromatic lustre: evidence for diffraction as a cause.

A human lens showing polychromatic lustre associated with cortical opacities (Christmas tree cataract) has been examined by slit-lamp photography, thin-section light microscopy, and electron microscopy. Anterior epithelial cells were fibroblast-like, and an area of breakdown of cortical lens fibres was observed in the anterior lens, containing feathery fibres, whorls, and process bodies. Parallel sided stacks of fused cell membranes were found beneath the watery area at the same depth as the polychromatic lustre seen in the slit-lamp. The dimensions of these membrane plates are consistent with the diffraction of light by a parallel thin film to give coloured points of light. Deeper areas of small granules between the lens fibres are associated with the main trunk-like opacity and its branches seen with the slit-lamp.

Aged↗
PubMed1998

Reproducibility of the laser flare meter and laser cell counter in assessing anterior chamber inflammation following cataract surgery.

BACKGROUND AND OBJECTIVES: To determine the interobserver and intraobserver reproducibility of the laser flare meter and laser cell counter in assessing anterior chamber inflammation following cataract surgery. PATIENTS AND METHODS: Thirty-nine eyes with varied degrees of inflammation and 9 normal eyes were included in the study. Anterior chamber flare and cells were evaluated with the slit lamp and graded on a scale of 0 to 4+. The flare and cells were then measured three times each using the flare meter and cell counter by two different, experienced observers. The intraobserver reproducibilities were computed to evaluate repeatability of the instruments operated by the same observer. The first measurement taken by each observer was used to assess reproducibility between the two observers. RESULTS: The intraobserver reproducibility for overall flare was 0.995 for both observers. The intraobserver reproducibility for overall cells was 0.996 for observer 1 and 0.991 for observer 2. The overall interobserver reproducibility was 0.994 for flare and 0.988 for cells. The correlation between measurements and slit-lamp ratings was 0.78 for flare and 0.56 for cells. CONCLUSIONS: The intraobserver and interobserver reproducibilities were excellent, with good correlation to slit-lamp measurements. Reproducible results can be obtained using the laser flare meter and the laser cell counter. It is not known whether these results are applicable to other inflammatory processes with higher grades of flare and cells and with different protein and cell types.

Anterior Chamber↗
PubMed2003

[The application of digital photography with retroillumination for lens in cataract study].

OBJECTIVE: To evaluate the reliability of digital photography with retroillumination for lens as a tool to assess the degree of lens opacity, and to study the morphological features of some lens diseases using the digital images. METHODS: The cataract screener (Neitz CT-S) was connected to a computer capable of acquiring digital images of lens. The digital lens retroillumination and slit lamp images were collected in 64 eyes. Three independent separate examiners took three sets of different CT-S digital photographs in four cataract subjects. The area of lens opacification in the images was measured and analyzed using threshold adjustment in PhotoShop software and a customized program in Matlab software. RESULTS: The distinct digital images of lens cortical opacity, posterior subcapsular opacity and other lens diseases were obtained with CT-S computer digital photography, which images were much better than slit lamp sectional digital images. The sensitivity and specificity of measuring lens opacification with CT-S digital images were 90% and 94% respectively. However, the digital lens retroillumination images were not as sensitive as the slit lamp images for nuclear cataracts. The variation coefficients of lens opacity area in the three sets of CT-S digital images in the same subject, which were taken by the independent examiners, were from 2.23% to 10.86%. The cortical opacification in CT-S digital images was linear, cuniform or clustered aggregate shadow configuration. The posterior subcapsular opacification was discal vacuolar or granular appearance. CONCLUSIONS: The reproducibility of the CT-S digital images taken by the independent examiners is excellent. This technique can objectively show cortical or posterior subcapsular opacities, but nuclear cataracts.

Adult↗
PubMed1999

Confocal microscopy in Bowman and stromal corneal dystrophies.

OBJECTIVE: To use confocal microscopy to demonstrate the similarity among three autosomal-dominant corneal dystrophies and the diversity of the deposit patterns within a single dystrophy. DESIGN: A prospective, comparative case series. PARTICIPANTS: Twenty patients (40 eyes) from 10 families suffering from Bowman or stromal dystrophy agreed to take part: 3 with Reis-Bückler dystrophy, 12 with granular dystrophy, and 5 with lattice type-I dystrophy. Of these, nine had recurrence in their grafts or after phototherapeutic keratectomy before the confocal examination. The confocal images of affected corneas were compared with those of ten normal control eyes (ten subjects). INTERVENTION: All patients were examined by slit-lamp biomicroscopy. Confocal microscopy was performed with Achroplan 40x/numeric aperture (NA) = 0.75 and 63x/NA = 0.9 water immersion objectives. Image analysis was used to identify the corneal epithelial and stromal deposits correlated with each disorder. MAIN OUTCOMES MEASURES: Selected images of the corneal layers were evaluated qualitatively for the size, shape, light scattering, and reflection of the deposits. RESULTS: Slit-lamp biomicroscopy showed stromal involvement in all affected eyes. Confocal microscopy identified epithelial deposits in 30% of the eyes and stromal deposits in all eyes. The deposits within the epithelium were revealed more clearly with the 63x/NA = 0.9 objective (higher numeric aperture). Some of the confocal findings near the Bowman layer were common for all three dystrophies. Normal control eyes showed no epithelial or stromal deposits, either by biomicroscopy or confocal microscopy. CONCLUSIONS: Confocal microscopy provides an in vivo evaluation of the deposits in the cornea, with a higher resolution than biomicroscopy. The confocal findings common to the three dystrophies may agree with previous hypotheses of the same genetic origin. It may be a useful adjunct to slit-lamp biomicroscopy, particularly when histopathologic studies cannot be performed.

Adolescent↗
PubMed1988

Use of photographic techniques to grade nuclear cataracts.

Methods for objectively documenting and grading different varieties of lens opacities are needed in order to conduct research on risk factors for cataracts. This study tested the feasibility and reliability of using two different photographic methods to grade nuclear opacities. Photographs were taken of 41 eyes using a regular Topcon SL-5D photo slit lamp, and using a Topcon SL-45 (Scheimpflug) camera. The photographs were graded against a set of four standard photographs of increasing nuclear opacification. Densitometric analyses were also performed on both sets of photographs. The clinical grade, on examination, of the nucleus was compared to the examiner's grade of each photograph. Agreement was fair between the examination results and the grading of the photographs. Inter-observer reliability was high (kappa = 0.71) with photographs taken using the photo slit lamp. Moreover, the severity grading of the photographs showed a good correlation with the severity of opacity as determined by densitometric analyses. On the basis of these data, and on the field experience, the use of photographs of the nucleus obtained by photo slit lamp may be used in epidemiological surveys.

Cataract↗
PubMed2001

Optical coherence tomography for the noninvasive evaluation of the cornea.

PURPOSE: To determine the optical coherence tomographic (OCT) characteristics of normal corneas and to characterize the OCT images of abnormal corneal lesions. METHODS: Eleven eyes from 10 patients were examined at the Cornea Service of the Nagoya University Hospital: 4 had corneal pathologies, 4 underwent keratoplasty, and 2 were normal controls; 1 enucleated eye was also examined. OCT (OCT 2000 Zeiss-Humphrey) was used to study the normal cornea and various corneal abnormalities. We compared the OCT images to the observations made by slit-lamp biomicroscopy. RESULTS: Fluid spaces were detected as black images. A highly reflective reflex was observed at the interface of different tissues, and intensive backscattering (reflex) was seen when the incident ray hit the laminated layers vertically. Corneal opacities were not clearly imaged when they were diffuse and mild, or when they were arranged axially in a small area, as was the scar of the graft-host junction. It was possible to obtain images from the region of the cornea that was not clearly visible by slit-lamp examination because of a corneal opacity. CONCLUSION: OCT is a noncontact and noninvasive technique that can be performed safely on diseased corneas. OCT can provide objective documentation of corneal disorders that cannot be obtained by slit-lamp examination. The use of OCT in conjunction with other conventional instruments should provide a more complete image of the cornea.

Adult↗