Objective: The aim of this work is to compare slit lamp (SL) examination and anterior segment optical coherence tomography (AS-OCT) for the evaluation of central infectious corneal perforation.

Patients and Methods: This observational study included 50 eyes with central infectious corneal perforation. Both examination modalities, SL and AS-OCT, performed the pre-treatment and post-treatment examinations.

Results: The progress of healing started from day 7, 5 eyes (10%) appeared to be healed by SL, and only 3 (6%) appeared to be healed by OCT. All eyes appeared to be healed in the 1st month, 39 (78%) of them appeared to be healed by OCT and 45 eyes (90%) appeared to be healed by the 2nd month, the final healed eyes were 46 (92%) at the 3rd month. The first appeared to be healed is the corneal epithelium as seen by both SL and OCT after one month, corneal stroma appeared to be entirely healed in the first month by SL but by OCT, 78% healed by the first month, and the rest (22%) had partial healing by OCT. In the third month, 92% had complete callous formation as seen by OCT and only 8% had partial or incomplete healing.

Conclusion: AS-OCT is a reliable non-invasive tool for the evaluation of corneal perforation and its progression of healing. It was superior and more accurate than SL in the assessment of corneal perforation as it provides information on wound healing and the surrounding corneal layers that can not be seen by the slit lamp.