Difference between revisions of "Eye"

Jump to navigation Jump to search

Eye (view source)

Revision as of 17:39, 17 November 2022

6,045 bytes added ,  17:39, 17 November 2022
no edit summary
 
(124 intermediate revisions by 2 users not shown)
Line 1: Line 1:
The '''eye''' is rarely seen by pathologists.  They go to neuropathologists.   
[[Image:Gray888.png|thumb|300px|Illustration of the eye. (Gray's Anatomy/WC)]]
[[Image:Optic nerve head and retina -- low mag.jpg|thumb|300px|Micrograph showing the optic nerve head and retina. [[H&E stain]]. (WC)]]
The '''eye''' is rarely seen by pathologists.  Typically, they go to neuropathologists, as the eye is really part of the brain.  The article also covers many of the lesions found around the eye.  The lacrimal gland is covered in the ''[[lacrimal gland]]'' article.  Eyelid lesions are covered in the ''[[eyelid]]'' article.   


An introduction to neuropathology is in the ''[[neuropathology]]'' article.
An introduction to neuropathology is in the ''[[neuropathology]]'' article.


==Histology==
=Procedures=
*Evisceration - eye muscles left intact.
*Enucleation.
*Exenteration - extensive resection.
 
=Anatomy=
===Anterior to posterior===
#Cornea.
#Iris.
#Lens.
#Conjunctiva - edge of cornea.
#Sclera.
#*Similar to cornea - normally has [[blood vessel]]s.
 
===Optic nerve===
*Surrounded by CSF.
*Covered by dura.
 
====Images====
<gallery>
Image: Optic nerve -- very low mag.jpg | CN II - very low mag. (WC)
Image: Optic nerve -- low mag.jpg | CN II - low mag. (WC)
Image: Optic nerve -- intermed mag.jpg | CN II - intermed. mag. (WC)
Image: Optic nerve -- high mag.jpg | CN II - high mag. (WC)
</gallery>
 
===Inside to outside===
#Retina.
#Retinal pigment epithelium (RPE).
#Choroid.
#Sclera.
 
====Image====
<gallery>
Image:Optic nerve head and retina -- low mag.jpg| Optic nerve head and retina - low mag. (WC)
</gallery>
 
===Anterior angle===
*Angle between cornea and iris.
 
===Canthi===
The canthi are where the upper and lower eyelids meet:
*Medial canthus.
*Lateral canthus.
 
Note:
*The most common malignant canthus lesion is [[basal cell carcinoma]].<ref>URL: [https://iovs.arvojournals.org/article.aspx?articleid=2372910 https://iovs.arvojournals.org/article.aspx?articleid=2372910]. Accessed on: 2022 Nov 17.</ref>
 
=Histology=
===Eye muscles===
*The muscles that move the eye have a high nerve:muscle ratio = ~1:4.<ref>Bilbao. 24 November 2010.</ref>
*The muscles that move the eye have a high nerve:muscle ratio = ~1:4.<ref>Bilbao. 24 November 2010.</ref>
**Other muscles in the body ~1:250.
**Other muscles in the body ~1:250.


Conjunctiva:<ref>URL: [http://www.lab.anhb.uwa.edu.au/mb140/corepages/eye/eye.htm http://www.lab.anhb.uwa.edu.au/mb140/corepages/eye/eye.htm]. Accessed on: 20 October 2011.</ref>
===Conjunctiva===
Features:<ref>URL: [http://www.lab.anhb.uwa.edu.au/mb140/corepages/eye/eye.htm http://www.lab.anhb.uwa.edu.au/mb140/corepages/eye/eye.htm]. Accessed on: 20 October 2011.</ref>
*Stratified squamous.
*Stratified squamous.
**May be stratified columnar
**May be stratified columnar
*Goblet cells.  
*Goblet cells.
 
===Cornea===
Layers:<ref>URL: [http://www.ophthobook.com/questions/question-name-the-layers-of-the-cornea-and-their-function http://www.ophthobook.com/questions/question-name-the-layers-of-the-cornea-and-their-function]. Accessed on: 26 January 2012.</ref>
#Epithelium layer.
#*Squamoid cells.
#Bowman's layer.
#*Indistinct.
#Stroma.
#*Fibrous tissue.
#*No blood vessels.
#Descemet’s layer.
#*Indistinct.
#*PAS -ve.
#Endothelium.
#*Single layer.
 
===Retina===
[[Image:Retina -- very high mag.jpg|thumb|right|300px|Retina. (WC)]]
Simplified structure - eosinophilic material separating:
#Intermediate size, round, pale-staining nuclei (ganglion cells).
#Two layers of small round nuclei (inner and outer nuclear layer).
#Eosinophilic ellipsoid structures - rods/cones (photoreceptors).
#Single layer of cuboidal cells (retinal pigment epithelium.
 
Detailed structure - in direction light travels:
#Inner limiting membrane.
#Nerve fibre layer.
#Ganglion layer.
#Inner plexiform layer.
#Inner nuclear layer.
#Outer plexiform layer.
#Outer nuclear layer.
#Layer of rods and cones.
#External limiting membrane.
#Retinal pigment epithelium.
 
====Images====
<gallery>
Image:Gray881.png | Retina - schematic. (WC/Gray's)
Image: Optic nerve head and retina -- low mag.jpg | Optic nerve & retina - low mag. (WC)
Image: Retina -- intermed mag.jpg | Retina - intermed. mag. (WC)
Image: Retina -- high mag.jpg | Retina - high mag. (WC)
</gallery>
www:
*[http://www.surgical-pathology.com/retina_image.htm Retina - histology (surgical-pathology.com)].
*[http://biology.clc.uc.edu/fankhauser/labs/anatomy_&_physiology/a&p202/special_senses/eye/histology_eye.htm Histology of the eye (clc.uc.edu)].
 
===Eye structures with melanocytes===
[[Melanoma]] may arise from these sites:
*Iris.
*Conjunctiva.
*Ciliary bodies.
*Choroid.
 
=Benign entities=
==Conjunctivitis==
===General===
*Benign.
*Never biopsied.
**It is an incidental finding in a biopsy for something else.
 
===Gross===
*Red eye.
 
===Microscopic===
Features:
*Conjunctival epithelium - stratified squamous epithelium with goblet cells.
*Inflammatory cells.
 
==Conjunctival cyst==
{{ Infobox external links
| Name          = Conjunctival cyst
| EHVSC          = 10173
| pathprotocols  =
| wikipedia      =
| pathoutlines  =
}}
===General===
*Rare.
*May be due to surgery, trauma, or congenital (very rare).<ref>{{Cite journal  | last1 = Robb | first1 = RM. | last2 = Elliott | first2 = AT. | last3 = Robson | first3 = CD. | title = Developmental conjunctival cyst of the eyelid in a child. | journal = J AAPOS | volume = 16 | issue = 2 | pages = 196-8 | month = Apr | year = 2012 | doi = 10.1016/j.jaapos.2012.02.001 | PMID = 22525180 }}</ref>
 
===Microscopic===
Features:
*Conjunctival mucosa with atypia.
**Stratified squamous epithelium with goblet cells.
 
DDx:
*Ocular surface squamous neoplasia.
**Cystic [[squamous cell carcinoma]].
 
Image:
*[http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3085152/figure/F0003/ Conjunctival cyst (nih.gov)].<ref name=pmid21572734>{{Cite journal  | last1 = Elshazly | first1 = LH. | title = A clinicopathologic study of excised conjunctival lesions. | journal = Middle East Afr J Ophthalmol | volume = 18 | issue = 1 | pages = 48-54 | month = Jan | year = 2011 | doi = 10.4103/0974-9233.75886 | PMID = 21572734 }}</ref>
 
===Sign out===
<pre>
CONJUNCTIVA, RIGHT SUPERIOR, BIOPSY:
- BENIGN CONJUNCTIVAL MUCOSA -- COMPATIBLE WITH CYST LINIG.
</pre>


==Pinguecula==
==Pinguecula==
*Plural ''Pingueculae''.
===General===
===General===
*Raizada ''et al.''<ref name=pmid1031388>{{Cite journal  | last1 = Raizada | first1 = IN. | last2 = Bhatnagar | first2 = NK. | title = Pinguecula and pterygium (a histopathological study). | journal = Indian J Ophthalmol | volume = 24 | issue = 2 | pages = 16-8 | month = Jul | year = 1976 | doi =  | PMID = 1031388 | URL = http://www.ijo.in/text.asp?2007/55/1/83/29517 }}</ref> suggest it is an early pterygium; however, this is disputed.
*Raizada ''et al.''<ref name=pmid1031388>{{Cite journal  | last1 = Raizada | first1 = IN. | last2 = Bhatnagar | first2 = NK. | title = Pinguecula and pterygium (a histopathological study). | journal = Indian J Ophthalmol | volume = 24 | issue = 2 | pages = 16-8 | month = Jul | year = 1976 | doi =  | PMID = 1031388 | URL = http://www.ijo.in/text.asp?2007/55/1/83/29517 }}</ref> suggest it is an early [[pterygium]]; however, this is disputed.
*Due to ultraviolet light exposure, e.g. sunlight.<ref name=pmid2695353>{{Cite journal  | last1 = Hill | first1 = JC. | last2 = Maske | first2 = R. | title = Pathogenesis of pterygium. | journal = Eye (Lond) | volume = 3 ( Pt 2) | issue =  | pages = 218-26 | month =  | year = 1989 | doi = 10.1038/eye.1989.31 | PMID = 2695353 | URL = http://www.nature.com/eye/journal/v3/n2/abs/eye198931a.html }}</ref>
*Due to ultraviolet light exposure, e.g. sunlight.<ref name=pmid2695353>{{Cite journal  | last1 = Hill | first1 = JC. | last2 = Maske | first2 = R. | title = Pathogenesis of pterygium. | journal = Eye (Lond) | volume = 3 ( Pt 2) | issue =  | pages = 218-26 | month =  | year = 1989 | doi = 10.1038/eye.1989.31 | PMID = 2695353 | URL = http://www.nature.com/eye/journal/v3/n2/abs/eye198931a.html }}</ref>
*Tend to be older than individuals afflicted with a pterygium.
*Tend to be older than individuals afflicted with a pterygium.
Line 27: Line 179:
==Pterygium==
==Pterygium==
*[[AKA]] surfer eye.
*[[AKA]] surfer eye.
{{Main|Pterygium}}
==Eccrine hidrocystoma==
*Occasionally spelled ''eccrine hydrocystoma''.<ref name=pmid10065300/>
{{Main|Eccrine hidrocystoma}}
==Chalazion==
{{Main|Chalazion}}
==Retinal hemorrhage==
:See ''[[Traumatic brain injury in infants]]''.
Image:
*[http://library.med.utah.edu/WebPath/jpeg2/FOR124.jpg Retinal haemorrhage (med.utah.edu)].<ref>URL: [http://library.med.utah.edu/WebPath/EXAM/IMGQUIZ/fofrm.html http://library.med.utah.edu/WebPath/EXAM/IMGQUIZ/fofrm.html]. Accessed on: 6 December 2010.</ref>
==Glaucoma==
===General===
===General===
*Pronounced: "tuh-rij-ee-uhm".<ref>URL: [http://dictionary.reference.com/browse/pterygium http://dictionary.reference.com/browse/pterygium]. Accessed on: 20 October 2011</ref>
*Leading cause of irreversible blindness.
*Conjunctiva lesion that covers part of the sclera.
 
**Sclera = white part of the eye.<ref>URL: [http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002006/ http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002006/]. Accessed on: 20 October 2011.</ref>
Classification:
*Benign.
*Open angle - more common.
*Due to ultraviolet light exposure, i.e. sunlight.<ref name=pmid2695353>{{Cite journal  | last1 = Hill | first1 = JC. | last2 = Maske | first2 = R. | title = Pathogenesis of pterygium. | journal = Eye (Lond) | volume = 3 ( Pt 2) | issue = | pages = 218-26 | month = | year = 1989 | doi = 10.1038/eye.1989.31 | PMID = 2695353 | URL = http://www.nature.com/eye/journal/v3/n2/abs/eye198931a.html }}</ref>
*Closed angle.
 
===Microscopic===
Features (closed angle):
*Cornea and iris opposed to one another.
 
==Retinal detachment==
===General===
*Blindness.
 
Causes:
*Trauma (classic) - pathologist doesn't usually see.
*Tumours - common in pathology specimens.
 
===Microscopic===
Features:
*Retina separated from retinal pigment epithelium.
*Eosinophilic exudate containing macrophages.
 
==Blepharochalasis==
===General===
*Rare, benign eyelid disorder.<ref name=pmid19298902>{{Cite journal  | last1 = Koursh | first1 = DM. | last2 = Modjtahedi | first2 = SP. | last3 = Selva | first3 = D. | last4 = Leibovitch | first4 = I. | title = The blepharochalasis syndrome. | journal = Surv Ophthalmol | volume = 54 | issue = 2 | pages = 235-44 | month =  | year =  | doi = 10.1016/j.survophthal.2008.12.005 | PMID = 19298902 }}</ref>
*Upper eyelids +/-lower eyelids (severe cases).<ref name=pmid19298902/>
 
Clinical:
*Swelling of eyelids - recurrent.<ref>{{Cite journal  | last1 = Bergin | first1 = DJ. | last2 = McCord | first2 = CD. | last3 = Berger | first3 = T. | last4 = Friedberg | first4 = H. | last5 = Waterhouse | first5 = W. | title = Blepharochalasis. | journal = Br J Ophthalmol | volume = 72 | issue = 11 | pages = 863-7 | month = Nov | year = 1988 | doi = | PMID = 3207663 }}</ref>
*Onset in childhood.
*Leads to ptosis.
 
Clinical DDx:<ref name=pmid19298902/>
*Recurrent angioedema.
*Hereditary angioedema.
*[[Contact dermatitis]].
*Melkersson-Rosenthal syndrome.
*Dermatochalasis.
*Floppy-eyelid syndrome.
*Lax eyelid syndrome.
*Cutis laxa.


Image:
Note:
*[http://trialx.com/curebyte/2011/05/31/what-does-pterygium-look-like/ Pterygium - gross (trialx.com)].
*The term may be abused; it may be used when an eyelid tuck is done for other reasons.{{fact}}


===Microscopic===
===Microscopic===
Features:<ref name=pmid2695353>{{Cite journal  | last1 = Hill | first1 = JC. | last2 = Maske | first2 = R. | title = Pathogenesis of pterygium. | journal = Eye (Lond) | volume = 3 ( Pt 2) | issue = | pages = 218-26 | month =  | year = 1989 | doi = 10.1038/eye.1989.31 | PMID = 2695353 | URL = http://www.nature.com/eye/journal/v3/n2/abs/eye198931a.html }}</ref>
Features:<ref name=pmid19298902>{{Cite journal  | last1 = Koursh | first1 = DM. | last2 = Modjtahedi | first2 = SP. | last3 = Selva | first3 = D. | last4 = Leibovitch | first4 = I. | title = The blepharochalasis syndrome. | journal = Surv Ophthalmol | volume = 54 | issue = 2 | pages = 235-44 | month =  | year = | doi = 10.1016/j.survophthal.2008.12.005 | PMID = 19298902 }}</ref>
*Hyaline material beneath epithelium.
*Edema.
*Elastic fibres beneath the hyaline material.
*+/-Inflammation.
*Solar elastosis.<ref name=uic_edu>URL: [http://www.uic.edu/depts/mcpt/eyepath/specco4.htm http://www.uic.edu/depts/mcpt/eyepath/specco4.htm]. Accessed on: 25 October 2011.</ref>
**Dense gray/light brown acellular material.
*Dilated vessels.<ref name=uic_edu>URL: [http://www.uic.edu/depts/mcpt/eyepath/specco4.htm http://www.uic.edu/depts/mcpt/eyepath/specco4.htm]. Accessed on: 25 October 2011.</ref>


DDx:
DDx:
*Squamous dysplasia.
*Angioedema.<ref name=pmid19380685>{{Cite journal  | last1 = Wang | first1 = G. | last2 = Li | first2 = C. | last3 = Gao | first3 = T. | title = Blepharochalasis: a rare condition misdiagnosed as recurrent angioedema. | journal = Arch Dermatol | volume = 145 | issue = 4 | pages = 498-9 | month = Apr | year = 2009 | doi = 10.1001/archdermatol.2009.19 | PMID = 19380685 }}</ref>
 
===Stains===
*Elastin stain - shows loss of elastin.<ref name=pmid15841657>{{Cite journal  | last1 = Kaneoya | first1 = K. | last2 = Momota | first2 = Y. | last3 = Hatamochi | first3 = A. | last4 = Matsumoto | first4 = F. | last5 = Arima | first5 = Y. | last6 = Miyachi | first6 = Y. | last7 = Shinkai | first7 = H. | last8 = Utani | first8 = A. | title = Elastin gene expression in blepharochalasis. | journal = J Dermatol | volume = 32 | issue = 1 | pages = 26-9 | month = Jan | year = 2005 | doi =  | PMID = 15841657 }}</ref>
 
===Sign out===
<pre>
EYELID, LEFT UPPER, PTOSIS REPAIR:
- SQUAMOUS EPITHELIUM WITHIN NORMAL LIMITS.
- SUBEPITHELIAL TISSUE WITH MILD EDEMA.
- SOLAR ELASTOSIS.
- NEGATIVE FOR MALIGNANCY.
</pre>
 
====Lower eyelids in an older individual labelled blepharochalasis====
<pre>
A. EYELID, LEFT LOWER, BLEPHAROPLASTY:
- BENIGN SKIN WITH MILD SOLAR ELASTOSIS.
- BENIGN SKELETAL MUSCLE AND ADIPOSE TISSUE.
- NEGATIVE FOR MALIGNANCY.


Images:
B. EYELID, RIGHT LOWER, BLEPHAROPLASTY:
*www:
- BENIGN SKIN WITH MILD SOLAR ELASTOSIS.
**[http://www.uic.edu/depts/mcpt/eyepath/specco4.htm Pterygium (uic.edu)].
- BENIGN SKELETAL MUSCLE AND ADIPOSE TISSUE.
*[[WC]]:
- NEGATIVE FOR MALIGNANCY.
**[http://commons.wikimedia.org/wiki/File:Pterygium_-_intermed_mag.jpg Pterygium - intermed. mag. (WC)].
</pre>
**[http://commons.wikimedia.org/wiki/File:Pterygium_-_high_mag.jpg Pterygium - high mag. (WC)].


==Eccrine hidrocystoma==
==Papilloma of the caruncle==
===General===
{{Main|Eye papilloma}}
*Benign.
*Eyelid lesion.


Clinical DDx:<ref name=pmid10065300/>
==Corneal ulcer==
*Cystic [[BCC]].
{{Main|Corneal ulcer}}


===Microsopic===
==Keratoconus==
Features:
{{Main|Keratoconus}}
*Same histology as [[epidermal inclusion cyst]].<ref name=pmid10065300>{{Cite journal  | last1 = Adams | first1 = SP. | title = Dermacase. Eccrine hydrocystoma. | journal = Can Fam Physician | volume = 45 | issue =  | pages = 297, 306 | month = Feb | year = 1999 | doi =  | PMID = 10065300 |PMC = 2328272 }}</ref>


==Retinoblastoma==
==Corneal scar==
===General===
===General===
*Rare.
*Trauma to the cornea.
*Malignant.
*May be familial.<ref name=pmid20687510>{{cite journal |author=Lohmann D |title=Retinoblastoma |journal=Adv. Exp. Med. Biol. |volume=685 |issue= |pages=220–7 |year=2010 |pmid=20687510 |doi= |url=}}</ref>


===Microscopic===
===Microscopic===
Features:
Features:
*[[Small round cell tumour]].
*Compact hyaline tissue - darker staining.
*Flexner-Wintersteiner [[rosette]] - '''key feature'''.
*Fibroblasts.
**Rosette with empty centre (donut hole).<ref name=pmid16551982>{{cite journal |author=Wippold FJ, Perry A |title=Neuropathology for the neuroradiologist: rosettes and pseudorosettes |journal=AJNR Am J Neuroradiol |volume=27 |issue=3 |pages=488–92 |year=2006 |month=March |pmid=16551982 |doi= |url=}}</ref>
 
*+/-Homer-Wright rosette.<ref>WH. 14 March 2011.</ref>
DDx:
**Circular rosette with neuropil at the centre.<ref name=pmid16551982>{{cite journal |author=Wippold FJ, Perry A |title=Neuropathology for the neuroradiologist: rosettes and pseudorosettes |journal=AJNR Am J Neuroradiol |volume=27 |issue=3 |pages=488–92 |year=2006 |month=March |pmid=16551982 |doi= |url=}}</ref>
*Squamous dysplasia.


Image:
===Sign out===
*[http://moon.ouhsc.edu/kfung/jty1/opaq/PathQuiz/O0A001-PQ01-M.htm Retinoblastoma (ouhsc.edu)].
<pre>
Corneal Button, Right Eye, Keratoplasty:
- Consistent with corneal scar.
- NEGATIVE for dysplasia.
</pre>


Notes:
==Conjunctival nevus==
*DDx of Flexner-Wintersteiner rosette includes: pineoblastomas, medulloepitheliomas.
{{Main|Conjunctival nevus}}


==Retinal hemorrhage==
=Tumours of the eye=
:See ''[[Traumatic brain injury in infants]]''.
==Optic glioma==
===General===
*Associated with [[Neurofibromatosis]] type 1.
* Often nerve sheath thickening or tortuosity.
* Approx 3% of all pediatric gliomas.
* Histology in most cases a [[pilocytic astrocytoma]].
 
==Retinoblastoma==
{{Main|Retinoblastoma}}


Image:
==Malignant melanoma==
*[http://library.med.utah.edu/WebPath/jpeg2/FOR124.jpg Retinal haemorrhage (med.utah.edu)].<ref>URL: [http://library.med.utah.edu/WebPath/EXAM/IMGQUIZ/fofrm.html http://library.med.utah.edu/WebPath/EXAM/IMGQUIZ/fofrm.html]. Accessed on: 6 December 2010.</ref>
{{Main|Malignant melanoma}}
Common malignancy in the eye in adults.


==See also==
=See also=
*[[CNS tumours]].
*[[Hypertension]].
*[[Hypertension]].
*[[Lacrimal gland]].
*[[Neuropathology]].
*[[Neuropathology]].
*[[CNS tumours]].
*[[Descemet's membrane]].


==References==
=References=
{{Reflist|2}}
{{Reflist|2}}


[[Category:Weird stuff]]
[[Category:Eye]]
[[Category:Neuropathology]]
[[Category:Neuropathology]]
Michael
48,466

edits

Retrieved from "https://librepathology.org/wiki/Special:MobileDiff/8984...52224"

Navigation menu