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Hacettepe University Faculty of Medicine, Department of Ophthalmology, Ankara/TURKEY Diabetic keratopathy is a multifactorial clinical entity involving the cornea and the ocular surface that is difficult to recognize and which is initiated by elevated tear glucose levels. This entity comprises several disease states including dry eye, recurrent corneal erosions and persistent epithelial defects. Epithelial erosions that occur following vitreoretinal procedures may be resistant to standard treatment modalities. Several mechanisms including corneal nerve damage, accumulation of advanced glycation end products, polyol pathway activation and loss of trophic factors contribute to disease pathogenesis. In addition alteration at the level of Descemet's membrane and endothelial cell layer may also be observed. In this aspect in vivo confocal microscopy has become a valuable diagnostic tool to observe the corneal changes associated with diabetic keratopathy. Although there is no effective treatment regimen for diabetic keratopathy, several different approaches are being developed to counteract the toxic effects of hyperglycemia on the cornea. Keywords : Diabetes, cornea, subbasal nerves, epithelium, in vivo confocal microscopy