9.2  Confocal Microscopy

Confocal microscopy can provide high magnification/high resolution optical sections of all layers of the cornea. Examination candidates should be familiar with various conditions which may be used in a data station, particularly:

  • Acanthamoeba Keratitis
  • Fungal Keratitis
  • Fuchs Endothelial Dystrophy
  • Iridocorneal Endothelial Syndrome
Figure 9.2.1 Normal Cornea

Figure 9.2.1
Normal Cornea

A: Superficial epithelium (note en face image and clearly depicted cell nuclei)
B: Epithelium (note borders of epithelial cells)
C: Stroma
D: Endothelium

Figure 9.2.2
Acanthamoeba Keratitis

Acanthamoeba cysts are brightly reflective round structures (arrow), which may have a less reflective ring around them. Active trophozoites are also highly reflective but more elongated.

Figure 9.2.3 Fungal Keratitis

Figure 9.2.3
Fungal Keratitis

Fungal elements (hyphae) are demonstrated.

Figure 9.2.4 Fuch’s Endothelial Dystrophy

Figure 9.2.4
Fuch’s Endothelial Dystrophy

Round hyporeflective bodies with central highlight (guttata).

Figure 9.2.5 Iridocorneal Endothelial Syndrome

Figure 9.2.5
Iridocorneal Endothelial Syndrome

A: Highly reflective nuclei, polymegathism and pleomorphism is demonstrated.
B (inset): Unaffected fellow eye.

Figure 9.2.6
Low Endothelial Cell Count

Large endothelial cells and pleomorphism are demonstrated

          

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