Common ocular conditions, such as glaucoma, uveitis and Fuchs endothelial dystrophy, may produce changes in the structure and function of the corneal endothelium (the inner most layer of the cornea only one cell thick!) that result in corneal edema (swelling) and visual impairment. Additionally, clinical circumstances, such as contact lens wear and intraocular surgery, may compromise the endothelium and cause corneal edema. An accurate diagnosis of endothelial disease may be the key in not only determining cause of corneal edema, but also in the management of these patients. Specular microscopy is a noninvasive photographic technique that allows you to visualize and analyze the corneal endothelium. Using computer-assisted “morphometry,” modern specular microscopes analyze the size, shape and population of these endothelial cells. The instrument projects light onto the cornea and captures the image that is reflected from the optical interface between the corneal endothelium and the aqueous humor. The reflected image is analyzed by the instrument and displayed as a specular photomicrograph. In clinical practice, specular microscopy is the most accurate way to examine the corneal endothelium. Not see more than a handful of these devices would be found in any large city. Having this powerful device as part of an optometric setting can set any practice apart from the competition. This technology allows us to manage our patients with confidence utilizing the most advanced technology available.