Corneal nerve imaging visualises the fine nerve fibres within the cornea, usually using in vivo confocal microscopy. It provides insight into ocular surface innervation and neuropathic conditions.
Technique
A confocal microscope captures high-magnification images of the sub-basal nerve plexus and deeper stromal nerves, often through a coupling gel and objective lens close to the corneal surface. Images show nerve density, branching, and morphology.
- Requires topical anaesthesia and patient cooperation
- Generates near histological resolution of nerve structures
- Specialised software can quantify fibre length and tortuosity
- Images are taken at multiple locations across the cornea
Clinical Applications
Corneal nerve imaging is used in research and selected clinical cases of dry eye disease, corneal neuropathy, diabetes, and post-surgical nerve regeneration. It helps link symptoms with structural nerve changes.
- Reduced nerve density may correlate with neuropathic pain or reduced sensitivity
- Monitoring can show recovery after procedures such as corneal transplantation or laser surgery
- Emerging role in systemic disease assessment, for example diabetic neuropathy
- Interpretation requires familiarity with normal variation and artefacts
