Corneal diagnostic procedures.

The cornea is the anterior, transparent portion of the fibrous tunic of the eye. It is continuous with the sclera at a transition called the limbus. In healthy conditions, the transparency of the cornea is maintained by the smooth, nonkeratinized, squamous epithelium, which is further enhanced by the precorneal tear film, the lack of corneal vascularization or pigmentation, the size and regular arrangement of the collagen fibrils that make up the corneal stroma, and the relative dehydration of the cornea (which is maintained by the endothelium and epithelium). The cornea can respond to adverse stimuli through vascularization, pigmentation, fibrosis, accumulation of cellular or noncellular infiltrate, and/or edema. Because of these limited responses, routine diagnostic procedures are critical in the diagnosis and treatment of corneal disorders. This article discusses tests of the precorneal tear film, corneal staining procedures, culture and sensitivity, cytology, and a few other procedures that are performed less commonly or require specialized instrumentation.