Corneal surface abnormalities are commonly encountered in ophthalmology and are manifestations of a wide range of underlying disease processes. The diversity of both clinical presentation and morphological appearance requires a systematic approach to the identification and management of these superficial corneal changes. Accurate diagnosis of superficial keratopathy requires skillful observation to seek the most characteristic clinical sign, a deductive thought process based on a knowledge of disease patterns, and occasionally the use of laboratory procedures to confirm the working diagnosis. We have classified changes of the corneal surface into five categories based on the clinical pattern (punctate, dendritic, plaque, vortex, and linear). We show how pattern recognition, with the aid of clinical presentation, history, and appropriate investigations, can lead to accurate diagnosis and initiation of proper management.