Imaging in anterior segment disorders

Purpose of review This review highlights the rapid advancements in anterior segment imaging and their relevance in enhancing the diagnosis and management of corneal disorders. Recent findings Innovations in imaging – including anterior segment optical coherence tomography (AS-OCT), Scheimpflug imaging, and in-vivo confocal microscopy (IVCM) – have transformed the evaluation of anterior segment pathology. These modalities enable detailed assessment of corneal morphology, thickness, and cellular integrity across various conditions such as keratitis, peripheral ulcerative keratitis, keratoconus, pellucid marginal degeneration, and Fuchs’ endothelial dystrophy. AS-OCT and IVCM are increasingly used to guide treatment decisions and monitor disease progression or surgical outcomes. In refractive surgery and ectatic disorder screening, devices like Pentacam and UBM offer critical preoperative insights. Aberrometry and meibography are key in enhancing postoperative outcomes. Intraoperative OCT (iOCT) improves precision in keratoplasty, while artificial intelligence enhanced imaging platforms offer real-time pathology recognition and risk stratification. The growing use of smartphone adapters and telemedicine platforms further supports remote care and follow-up, particularly in resource-limited settings. Summary Multimodal imaging has become integral to anterior segment disease management, enabling early diagnosis, refined surgical planning, and improved visual outcomes. Ongoing research into artificial intelligence and integrated imaging systems promises even greater clinical efficiency and diagnostic accuracy in the near future.