Microscopy session February 2017

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.


Case 1
Lid and epibulbar lesion in a young patient

Low power view
Low power view

Medium power view
Medium power view

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).


Case 2
Cornea (DALK) specimen from a young adult

Low power view of cornea
Low power view of cornea
Mid power view of cornea
Mid power view of cornea

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.


Case 3
Enucleation for blind painful eye

Low power view of anterior part of eye
Low power view of anterior part of eye
Medium power view of anterior part of eye
Medium power view of anterior part of 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.


Case 4
Evisceration following longstanding disease and treatment

Mid power view of evisceration
Mid power view of evisceration
High power view of iris from evisceration
High power view of iris from evisceration

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!

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