In vivo confocal microscopy in the acute phase of corneal inflammation

Two cases of noninfectious keratitis were studied using in vivo corneal confocal microscopy in addition to routine slit-lamp biomicroscopy. A 10-year-old boy suffered from keratitis in his left eye due to a bee sting and a 20-year-old man had keratitis following corneal blunt trauma. In both cases, we found a honeycomb pattern at the anterior and mid-stromal level of the middle cornea. This honeycomb pattern disappeared in 1 week with steroid treatment. This pattern might be caused by syncytial cell bodies of activated keratocytes, by focal corneal stroma edema, or by polymorphonuclear leukocyte infiltration along with the keratocytes or along preformed channels within the corneal stroma known as Bowman channels. Further analysis in a large number of patients may aid in further understanding in vivo human corneal inflammation.