Background: New imaging technologies are revolutionizing the understanding and treatment of a wide variety of ocular disorders. Confocal scanning laser ophthalmoscopy, ultrasound biomicroscopy, confocal scanning laser polarimetry, color doppler imaging of blood flow, and optical coherence tomography are providing important information regarding disease pathophysiology, diagnosis, progression, and treatment.

Methods: High frequency (50 MHz), high resolution ultrasound biomicroscopy of the anterior segment was obtained in a wide variety of disorders of the anterior segment. Tissue resolution is approximately 50 microns and the penetration depth is 5 mm.

Results: Ultrasound biomicroscopy is capable of imaging the comea, iris, anterior chamber, anterior chamber angle, posterior chamber, and ciliary body with great detail. The structures surrounding the posterior chamber, previously hidden from clinical observation, can be imaged and their normal anatomic relationships assessed. The various forms of angle closure glaucoma, such as pupillary block and plateau iris configuration, can be differentiated. The concave iris found in pigment dispersion and its response to treatment can be assessed. Visualization of anterior segment anatomy in eyes with opaque media is possible.

Conclusions: Ultrasound biomicroscopy assists in the management of eyes with disorders of the anterior segment. Future applications of this technology will yield important information regarding accommodation, normal ocular physiology and disease pathophysiology.