[Imaging the ocular surface with confocal microscopy: histology without samples]

Developed in the 1990s, confocal microscopy contributed a new way of viewing corneal structures at levels close to those of histology. However, these systems were expensive, difficult to handle and use, had poor resolution, and were not usable for more superficial or peripheral structures. These devices were therefore restricted to research and were not used routinely in clinical practice. New-generation devices such as the HRT Rostock Cornea Module recently provided a new approach with high-resolution, fully digital images of the entire ocular surface, including limbus and conjunctiva. These images are close to those obtained ex vivo using histological procedures. The technique is painless and minimally invasive. Confocal microscopy should therefore become a very helpful means to explore ocular surface diseases in the near future.