Ophthalmic Histopathology

CHAPTER 1 EXAMINATION OF THE GLOBE. TECHNICAL ASPECTS: 1.1.1 Introduction 1.1.2 Clinical correlation 1.1.2.1 Background information 1.1.2.2 Clinical techniques for illustration and documentation 1.2 Equipment for macroscopic examination 1.3 Basic gross anatomy: External features 1.3.1 Measurement of ocular dimensions 1.3.2 The anterior segment 1.3.2.1 The cornea 1.3.2.2 The anterior chamber 1.3.2.3 The anterior sclera 1.3.3 The posterior aspect 1.3.3.1 The optic nerve 1.3.3.2 The vortex veins 1.3.4 Orientation of the primary cuts into the globe 1.3.4.1 Transillumination 1.3.4.2 Vertical calottes 1.3.4.3 Horizontal calottes 1.3.4.4 Oblique calottes 1.3.4.5 The unfixed globe 1.4 Basic gross anatomy: Internal features 1.4.1 Examination of specific features 1.4.2 Retrieval of tissue from the calottes 1.5 Radiological examination of the globe 1.6 Common artefacts 1.6.1 Myelin artefact 1.6.2 Shrinkage artefact 1.6.3. Autopsy material 1.7 Fixation techniques 1.7.1 Formalin based fixatives p11 1.7.1.1 Formaldehyde 1.7.1.2 Formal acetic methanol 1.7.2 Paraformaldehyde 1.7.3 Glutaraldehyde 1.8 Embedding techniques 1.8.1 General considerations 1.8.2 Paraffin wax 1.8.3 Celloidin 1.8.4 Plastic embedding 1.8.5 The importance of serial sections 1.9 Histological examination of a section of the globe 1.10 Specialised techniques 1.10.1 Introduction 1.10.2 Retinal digest preparations 1.10.3 Injection techniques (carbon, plastic) 1.11 Stains for microscopy 1.11.1 Conventional stains 1.11.2. Frozen sections for fat 1.11.3. Immunohistochemistry 1.11.3.1 Identification of tissue proteins by immune labelling 1.11.4 Silver stains for nucleolar organising regions (AgNOR's) 1.11.5 In situ hybridisation 1.11.6. Polymerase chain reaction 1.11.7. Techniques for identification of proliferation and apoptosis in cells. 1.12 Techniques for illustration and documentation 1.12.1 Photomacrography l.11.2 Photomicrography 1.12 Fluorescence microscopy 1.13 Polarised light/interference contrast microscopy 1.15 Electron microscopy 1.16 Diagnostic cytopathology 1.17 Normal ocular histology CHAPTER 2 THE TRAUMATISED EYE: 2.1 Introduction 2.2 The irreparable eye 2.2.1 Large penetrating or perforating wounds of the corneoscleral envelope. 2.2.2 Macroscopic examination 2.2.3 Microscopic examination 2.3 The globe removed after unsuccessful attempts at repair 2.3.0 Introduction 2.3.1 Reparative changes in ocular tissues 2.3.1.1 Fibrous ingrowth 2.3.1.2 Organisation of blood 2.3.1.3 Hypotonia 2.3.1.4 Retina and optic nerve 2.3.1.5 Photoreceptor fragmentation 2.3.1.6 Lens 2.3.1.7 Haemosiderosis bulbi 2.4 Globe containing a metallic foreign body 2.4.1 Macroscopic examination 2.4.2 Types of and effects of metallic foreign bodies 2.4.3 Siderosis 2.4.4 Chalcosis 2.5 Long-term effects of ocular trauma 2.5.0 Introduction 2.5.1 Macroscopic 2.5.2 Post-traumatic glaucoma 2.5.2.1 Secondary angle closure 2.5.2.2 Secondary open angle glaucoma 2.5.2.2.1 Angle recession 2.5.2.2.2 Epithelial downgrowth 2.5.3 Lens abnormalities 2.5.3.1 Lens dislocation 2.5.3.2 Lens induced uveitis 2.5.4 Post traumatic retinal pathology 2.5.4.1 General 2.5.4.1 Post-traumatic pseudoretinitis pigmentosa 2.5.5 Sympathetic ophthalmitis 2.5.5.1 Introduction 2.5.5.2 Macroscopic examination 2.5.5.3 Microscopic examination 2.5.5.4 Research 2.6 Phthisis bulbi, ocular atrophy and ossification 2.6.1 General 2.6.2 Cyclitic membrane 2.6.3 Lens pathology in a phthisical eye 2.6.4 Retinal gliosis 2.6.5 Retinal pigment epithelium in phthisis bulbi 2.6.6 The choroid in phthisis bulbi 2.6.7 The optic nerve 2.7 Hot metals, acid burns and alkali burns 2.8 Ionising radiation