In vivo observation of the corneal epithelium

Specular microscopy is an important addition to the ophthalmologist's diagnostic armamentarium. Using this technique, it has been found that normal corneal epithelial cells are polygonal, with no abnormal specular reflex. There are no spindle‐shaped, large or small cells, as may be observed in a variety of pathologic conditions. Spindle‐shaped cells are characteristic of the wound‐healing process with cell migration. Large cells were observed not only in wound healing, but also in aphakic diabetic patients, extended‐wear soft contact lens wearers, and individuals with keratoconus. These changes may result from depressed mitosis or inhibited sloughing of superficial cells. Morphometric analysis adds a quantitative dimension to epithelial cell analysis.