Recent studies have shown that dendritic cells and T cells in the cornea are critically associated with corneal nerve innervation [1, 2]. This has been shown in both human and animal studies [1-4]. At the same time, the technology for in vivo imaging of human corneal nerves and dendritic cells and their quantification have greatly improved recently. This has led to an explosion of interest in harnessing this technology as a surrogate marker for peripheral neuropathies and to explore underlying mechanisms [5-27]. The investigators have previously shown that first generation CCM can quantify the presence and density of Langerhans cells (LCs) in Bowman's layer of the cornea in patients with diabetes [28]. However the latest 3rd generation HRT III can be used to classify and quantify Langerhans cells (LCs) into a mature phenotype (dendritic cell bearing long processes) or an immature phenotype (non-dendritic cell lacking cell dendrites) to provide insight into immune alterations in vivo [29]. A recent experimental study in diabetic mice has used CCM to show that direct contact between DCs and the corneal nerves may trigger nerve fiber damage [30].