Moorfields HDT – February 2018

Instead of a multiheader discussion this month, we had a Half Day Teaching session on eye pathology, attended by the Moorfields trainee ophthalmologists (and a few other guests – you know who you are!) We briefly ran over a few housekeeping topics, which I’ll note here as a reminder, then covered common stains used in histology (with the emphasis on ophthalmic pathology) and some basic histology and descriptive terms, finishing up with a quiz which hopefully allowed attendees to try out their new knowledge. I’ll post a selection of the quiz questions here if you want to have another look.

This is normal respiratory epithelium – not seen all that often in ophthalmic pathology practice

As a bonus, John Mould, Veterinary Ophthalmologist from Herefordshire, delivered a fantastic talk titled “Could you make it in veterinary ophthalmology?” John also gave a quiz on eye conditions in cats and dogs, and it was fascinating to see the similarities and differences in diseases.

Housekeeping topics

Updated cytology protocol – if you work for a service that submits vitreous cytology specimens, please note that the Department of Eye Pathology has updated its protocol to simplify specimen handling by the submitting clinician. No longer does the protocol depend on whether the sample is taken within or outside working hours. The new form and instructions are available here.
Marking sutures – if you work in a service that submits orientated specimens (eg eyelid skin), you may be in the habit of using marking sutures to indicate specimen orientation. This is standard practice, but please be aware that by the time the specimen arrives in the department in the formalin pot, it can be very difficult to identify fine sutures. Conversely, thick, braided suture material is more likely to traumatise the specimen.
How many specimens should a pot contain? If a pot contains multiple pieces of tissue from different sites, the pathologist may not be able to tell which is which. We’re not going to be prescriptive and say that each specimen pot should only contain one piece of tissue. However, ask yourself if it’s important to you to be able to differentiate what sites you sampled if one of the specimens turns out to have a sinister diagnosis.
Formalin works best at room temperature. Last year, a couple of cases in formalin pots somehow ended up in a freezer before arriving with us. The formalin froze, forming ice crystals, which traumatised the tissue. This made providing a diagnosis very difficult.

Quiz

And finally, here are some of the cases we looked at during yesterday’s quiz. I hope you found them useful.

March teaching

Next month’s microscopy session will be on Wednesday 13 March. As usual, I’ll circulate a sign up sheet in advance – hope to see some of you there!

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