This month we looked at a selection of cases with Cerys and Karla, who both have a special interest in cornea.
Corneal cases included macular dystrophy, recurrent lattice dystrophy and keratoconus. We then expanded the discussion to include intraocular pathology with retinal detachment and uveal melanoma.
Here are some highlights.
Lid and epibulbar lesion in a young patient
This is fibrofatty tissue with an epidermal-type covering including hair. In the central portion is some mature cartilage. This is a dermoid (complex choristoma).
Cornea (DALK) specimen from a young adult
The specimen includes anterior lamella and separate stroma. The stroma has small rounded holes following intraoperative gas injection. The eipithelium is centrally thinned. There are also peripheral large stromal spaces with a little surrounding inflammation and scarring. This patient has keratoconus, which has previously been managed with an intrastromal ring, hence the empty profiles at the periphery.
Enucleation for blind painful eye
The low power image shows the anterior portion of the eye. The anterior iris contour is flattened, which probably reflects rubeosis and/or neodescemetisation. Posterior to the iris there is striking bone formation. In the posterior segment, there is disorganised retina and proliferative vitreoretinopathy. This is, broadly speaking, an “end stage” eye.
Evisceration following longstanding disease and treatment
The mid power image shows residual choroid (to the left) and some fibrosis to the right. In this and the high power image of the iris, there are rounded optically empty spaces associated with melanin pigment. This appearance is a finding in eyes which have previously injected with silicone oil, which is used during management of retinal detachments.
See you next month!