Iew is to present and update readers on the evaluation of cornea and ocular surface. This first part reviews a description of slit lamp biomicroscopy (SLB), endothelial specular microscopy, confocal microscopy, and ultrasound biomicroscopy examination techniques and the second part describes the corneal topography and tomography, providing up-to-date information on the clinical recommendations of these techniques in eye care practice. Although the SLB is a traditional technique, it is of paramount importance in clinical diagnosis and compulsory when an eye test is conducted in primary or specialist eye care practice. Different techniques allow the early diagnosis of many diseases, especially when clinical signs have not yet become apparent and visible with SLB. These techniques also allow for patient follow-up in several clinical conditions or diseases, facilitating clinical decisions and improving knowledge regarding the corneal anatomy....

And this second part, reviews a description of the corneal topography and tomography techniques, providing updated information of the clinical recommendations of these techniques in eye care practice. Placido-based topographers started an exciting anterior corneal surface analysis that allows the development of current corneal tomographers that provide a full three-dimensional reconstruction of the cornea including elevation, curvature, and pachymetry data of anterior and posterior corneal surfaces. Although, there is not an accepted reference standard technology for corneal topography description and it is not possible to determine which device produces the most accurate topographic measurements, placido-based topographers are a valuable technology to be used in primary eye care and corneal tomograhers expanding the possibilities to explore cornea and anterior eye facilitating diagnosis and follow-up in several situations, raising patient follow-up, and improving the knowledge regarding to the corneal anatomy. Main disadvantages of placido-based topographers include the absence of information about the posterior corneal surface and limited corneal surface coverage without data from the para-central and/or peripheral corneal surface. However, corneal tomographers show repeatable anterior and posterior corneal surfaces measurements, providing full corneal thickness data improving cornea, and anterior surface assessment. However, differences between devices suggest that they are not interchangeable in clinical practice....

There are many contact lens-related ocular surface disorders. Some can damage the limbal region where stem cells are thought to be located in its basal cell layer. This damage can result in destruction and a deficiency of corneal stem cells. One important sign of this complication is corneal conjunctivalisation. The purpose of this study is to describe clinical characteristics of a series of long-standing contact lens (CL) wearers with corneal conjunctivalisation (CC). In a one-year (March 2004 to March 2005) retrospective unmasked study, 591 CL clinical histories (195 new patients and 396 review patients) were analysed. There were 24 eyes of 14 myopic patients (93 per cent women) with CC without a specific disease entity known to cause limbal stem cell deficiency (LSCD). Conjunctivalisation occurred in the inferior limbus of three eyes (12 per cent). Only four patients (28.6 per cent) reported previous ocular symptoms. All were myopic with a mean spherical equivalent of -8.80 +/- 5.00 (SD) dioptres (range from -1.75 to -21.50 D) and mean visual acuity 0.9 +/- 0.2 (range from 0.4 to 1.2). The mean years of CL wear was 17.6 +/- 8.5 (CI 95% 13.2 to 22; range six to 30). All were daily-wear patients with a mean daily-wear time of 12.5 +/- 1.8 hours per day (CI 95% 11.6 to 13.4). Corneal conjunctivalisation is a contact lens-related complication in asymptomatic patients. Optometrists can play an important role in early diagnosis, education and management of these patients.