Eye

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The eye is rarely seen by pathologists. They go to neuropathologists.

An introduction to neuropathology is in the neuropathology article.

Anatomy

Anterior to posterior:

  1. Cornea.
  2. Iris.
  3. Lens.
  4. Conjunctiva - edge of cornea.
  5. Sclera.
    • Similar to cornea - normally has blood vessels.

Inside to outside:

  1. Retina.
  2. Retinal pigment epithelium (RPE).
  3. Choroid.
  4. Sclera.

Cornea

Layers:[1]

  1. Epithelium layer.
    • Squamoid cells.
  2. Bowman's layer.
    • Indistinct.
  3. Stroma.
    • Fibrous tissue.
    • No blood vessels.
  4. Descemet’s layer.
    • Indistinct.
    • PAS _ve.
  5. Endothelium.
    • Single layer.

Anterior angle

  • Angle between cornea and iris.

Histology

  • The muscles that move the eye have a high nerve:muscle ratio = ~1:4.[2]
    • Other muscles in the body ~1:250.

Conjunctiva:[3]

  • Stratified squamous.
    • May be stratified columnar
  • Goblet cells.

Eye structures with melanocytes:

  • Iris.
  • Conjunctiva.
  • Ciliary bodies.
  • Choroid.

Pinguecula

  • Plural Pingueculae.

General

  • Raizada et al.[4] suggest it is an early pterygium; however, this is disputed.
  • Due to ultraviolet light exposure, e.g. sunlight.[5]
  • Tend to be older than individuals afflicted with a pterygium.

Gross

  • Yellow spot.

Microscopic

Features:

  • Similar to pterygium.[5]

Pterygium

  • AKA surfer eye.

General

  • Pronounced: "tuh-rij-ee-uhm".[6]
  • Conjunctiva lesion that covers part of the sclera.
    • Sclera = white part of the eye.[7]
  • Benign.
  • Due to ultraviolet light exposure, i.e. sunlight.[5]

Image:

Microscopic

Features:[5]

  • Hyaline material beneath epithelium.
  • Elastic fibres beneath the hyaline material.
  • +/-Inflammation.
  • Solar elastosis.[8]
    • Dense gray/light brown acellular material.
  • Dilated vessels.[8]

DDx:

  • Squamous dysplasia.

Images:

Eccrine hidrocystoma

General

  • Benign.
  • Eyelid lesion.

Clinical DDx:[9]

Microsopic

Features:

Retinoblastoma

General

  • Rare.
  • Malignant.
  • May be familial.[10]

Microscopic

Features:

Image:

Notes:

  • DDx of Flexner-Wintersteiner rosette includes: pineoblastomas, medulloepitheliomas.

Chalazion

General

  • Benign eye thing.

Microscopic

Features:

  • Granulomatous inflammation.[13]
    • Around clear space (lipid).
  • Plasma cells.

Image:

Retinal hemorrhage

See Traumatic brain injury in infants.

Image:

See also

References

  1. URL: http://www.ophthobook.com/questions/question-name-the-layers-of-the-cornea-and-their-function. Accessed on: 26 January 2012.
  2. Bilbao. 24 November 2010.
  3. URL: http://www.lab.anhb.uwa.edu.au/mb140/corepages/eye/eye.htm. Accessed on: 20 October 2011.
  4. Raizada, IN.; Bhatnagar, NK. (Jul 1976). "Pinguecula and pterygium (a histopathological study).". Indian J Ophthalmol 24 (2): 16-8. PMID 1031388.
  5. 5.0 5.1 5.2 5.3 Hill, JC.; Maske, R. (1989). "Pathogenesis of pterygium.". Eye (Lond) 3 ( Pt 2): 218-26. doi:10.1038/eye.1989.31. PMID 2695353.
  6. URL: http://dictionary.reference.com/browse/pterygium. Accessed on: 20 October 2011
  7. URL: http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002006/. Accessed on: 20 October 2011.
  8. 8.0 8.1 URL: http://www.uic.edu/depts/mcpt/eyepath/specco4.htm. Accessed on: 25 October 2011.
  9. 9.0 9.1 Adams, SP. (Feb 1999). "Dermacase. Eccrine hydrocystoma.". Can Fam Physician 45: 297, 306. PMC 2328272. PMID 10065300. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2328272/.
  10. Lohmann D (2010). "Retinoblastoma". Adv. Exp. Med. Biol. 685: 220–7. PMID 20687510.
  11. 11.0 11.1 Wippold FJ, Perry A (March 2006). "Neuropathology for the neuroradiologist: rosettes and pseudorosettes". AJNR Am J Neuroradiol 27 (3): 488–92. PMID 16551982.
  12. WH. 14 March 2011.
  13. D'hermies, F.; Fayet, B.; Meyer, A.; Morel, X.; Halhal, M.; Elmaleh, C.; Azan, F.; Behar-Cohen, F. et al. (Feb 2004). "[Chalazion mimicking an eyelid tumor].". J Fr Ophtalmol 27 (2): 202-5. PMID 15029054.
  14. URL: http://www.surgical-pathology.com/chalazion.htm. Accessed on: 24 January 2012.
  15. URL: http://library.med.utah.edu/WebPath/EXAM/IMGQUIZ/fofrm.html. Accessed on: 6 December 2010.