In vivo confocal microscopy in a case of pterygium

Pterygium is a frequent ocular surface disorder of unknown origin characterized by chronic conjunctival inflammation with a clear central cornea in most patients. A 35-year-old man affected by pterygium in the right eye presented with unremarkable slit-lamp examination of the central cornea, in which in vivo confocal microscopy showed a significant alteration of the superficial epithelial cells, numerous dendritic-like cells in the basal epithelial layer, and loss of keratocytes in the stroma. In vivo confocal microscopy may be helpful in evaluating the immunological and structural changes of the cornea in patients with pterygium and in understanding its pathophysiology.