Confocal microscopy of corneal penetration by tarantula hairs.

In vivo identification of foreign bodies in the cornea may be impossible if the size and/or location precludes visualization by slit lamp biomicroscopy, which has an upper limit of magnification of 50x. These limitations became obvious when we attempted to identify the offending material in the inflamed eye of a patient who complained of foreign body sensation after contact with a pet tarantula. As a model of this clinical situation, we used a newly developed tandem scanning confocal microscope to observe and to photograph tarantula hairs as they penetrated the corneal stroma and endothelium and entered the anterior chamber in rabbit eyes. We found that, experimentally, the hairs penetrated the ocular tissues apparently without inciting inflammation or causing fibrosis. The instrument we used--a prototype with a Nipkow disk from Noran, Inc. (Middleton, Wis.) and a 25/0.8 na glycerin immersion lens (Plan-Neofluor, Zeiss)--provides magnifications of 100-500x, real-time viewing in vivo, optical sectioning, contrast control, high resolution, processing through image analysis systems, and video and hard copy output. We believe that confocal microscopy offers a new approach to the identification and localization of foreign bodies in the anterior segment, as well as to the visualization and diagnosis of ocular diseases, including bacterial, fungal, and other parasitic invasions, in the human eye.