Clinical Applications of Anterior Segment Optical Coherence Tomography: An Updated Review Anterior segment optical coherence tomography (AS-OCT) has become an essential tool in ophthalmology for assessing and monitoring anterior segment structures, including the cornea, conjunctiva, sclera, anterior chamber, and iris. This review provides a comprehensive overview of the clinical applications of AS-OCT for various anterior segment pathologies, such as conjunctival neoplasia, pterygium, scleritis, keratoconus, corneal dystrophies, and infectious/noninfectious keratitis. It also discusses the use of AS-OCT in preoperative planning and postoperative monitoring for corneal and refractive surgeries. AS-OCT is a safe, non-invasive imaging modality that provides high-resolution images of the anterior segment. It has been shown to be particularly useful in the diagnosis and monitoring of conjunctival tumors, including benign and malignant lesions. AS-OCT can detect intralesional cysts in conjunctival naevi with high sensitivity, which is superior to other imaging modalities such as slit-lamp and ultrasound biomicroscopy. In the context of scleral diseases, AS-OCT can help differentiate between episcleritis and scleritis by identifying increased hyporeflective spaces at variable depths, corresponding to dilated superficial and deep episcleral blood vessels. In corneal diseases, AS-OCT has been shown to be a valuable diagnostic tool for keratoconus, providing quantitative pachymetry maps and epithelial mapping. It can also detect acute corneal hydrops, which is a severe complication of keratoconus, by visualizing the integrity of the pre-Descemet layer/Descemet membrane. AS-OCT is also useful in the diagnosis and management of keratitis, providing a more reliable and objective method of quantifying and monitoring the disease process. It can detect inflammatory cells and infiltrates in the cornea, as well as assess the depth and extent of corneal ulceration. In the case of infectious keratitis, AS-OCT can detect corneal perforation before it is apparent on slit-lamp examination. In corneal and refractive surgeries, AS-OCT plays an increasing role in preoperative and intraoperative stages, particularly in corneal transplantation. It can help assess the graft-host junction and detect complications such as graft detachment. In refractive surgery, AS-OCT can confirm the diagnosis of interface fluid syndrome and detect flap displacement/dislocation. It is also useful in the monitoring of epithelial ingrowth, a rare but sight-threatening complication that can occur after various ocular surgeries. Overall, AS-OCT has the potential to revolutionize the clinical examination of anterior segment structures, much like how the introduction of the slit lamp revolutionized the ocular examination in its time. Its ability to provide high-resolution images of the anterior segment makes itClinical Applications of Anterior Segment Optical Coherence Tomography: An Updated Review Anterior segment optical coherence tomography (AS-OCT) has become an essential tool in ophthalmology for assessing and monitoring anterior segment structures, including the cornea, conjunctiva, sclera, anterior chamber, and iris. This review provides a comprehensive overview of the clinical applications of AS-OCT for various anterior segment pathologies, such as conjunctival neoplasia, pterygium, scleritis, keratoconus, corneal dystrophies, and infectious/noninfectious keratitis. It also discusses the use of AS-OCT in preoperative planning and postoperative monitoring for corneal and refractive surgeries. AS-OCT is a safe, non-invasive imaging modality that provides high-resolution images of the anterior segment. It has been shown to be particularly useful in the diagnosis and monitoring of conjunctival tumors, including benign and malignant lesions. AS-OCT can detect intralesional cysts in conjunctival naevi with high sensitivity, which is superior to other imaging modalities such as slit-lamp and ultrasound biomicroscopy. In the context of scleral diseases, AS-OCT can help differentiate between episcleritis and scleritis by identifying increased hyporeflective spaces at variable depths, corresponding to dilated superficial and deep episcleral blood vessels. In corneal diseases, AS-OCT has been shown to be a valuable diagnostic tool for keratoconus, providing quantitative pachymetry maps and epithelial mapping. It can also detect acute corneal hydrops, which is a severe complication of keratoconus, by visualizing the integrity of the pre-Descemet layer/Descemet membrane. AS-OCT is also useful in the diagnosis and management of keratitis, providing a more reliable and objective method of quantifying and monitoring the disease process. It can detect inflammatory cells and infiltrates in the cornea, as well as assess the depth and extent of corneal ulceration. In the case of infectious keratitis, AS-OCT can detect corneal perforation before it is apparent on slit-lamp examination. In corneal and refractive surgeries, AS-OCT plays an increasing role in preoperative and intraoperative stages, particularly in corneal transplantation. It can help assess the graft-host junction and detect complications such as graft detachment. In refractive surgery, AS-OCT can confirm the diagnosis of interface fluid syndrome and detect flap displacement/dislocation. It is also useful in the monitoring of epithelial ingrowth, a rare but sight-threatening complication that can occur after various ocular surgeries. Overall, AS-OCT has the potential to revolutionize the clinical examination of anterior segment structures, much like how the introduction of the slit lamp revolutionized the ocular examination in its time. Its ability to provide high-resolution images of the anterior segment makes it