Ophthalmic Pathology

Ophthalmic pathologists dedicate their medical practice to the pathological analysis of tissues from the eye and ocular adnexa. Ophthalmic pathology is the subspecialty of surgical pathology and also a subspecialty of ophthalmology which deals with the diagnosis and characterization of neoplastic and non-neoplastic diseases of the eyes.

Therapath is equipped with state of the art facilities: immunohistochemical, immunoflourescence and light microscopy services with access to electron microscopy and whole slide imaging technology as well.

Specimen Processing: Standard processing includes stained sections placed on charged slides. After staining and drying, they are presented to the pathologist for evaluation for each specimen.

Analysis and Reporting: The Laboratory Information System will be used to record the pathologists qualitative evaluation. The report will be released to the referring physician, surgeon and/or pathology department via web portal access, fax or mail. At the time of the first specimen referral, the reporting preferences will be established in our system.



Examples of Ophthalmic Specimen Analysis 

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1. Gelatinous drop-like corneal dystrophy is characterized by ropy thick amyloid deposits underneath Bowman’s layer and in anterior stroma without accompanying epithelial erosion. It is an autosomal recessive dystrophy with adult age onset. It is caused by genetic defects in keratoepithelin gene (also known as transforming growth factor, beta-induced gene or TGFBI) on chromosome 5.
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2. Sebaceous carcinoma is a relatively frequent malignancy of the eyelids. It often arises in meibomian glands but rarely also in glands of Zeis. It is an aggressive malignancy masquerading often times as chalazia delaying the initial diagnosis. Histologically it shows prominent nuclear pleomorphism, frequent mitoses, extensive intercellular bridging, and occasional cells with ample cytoplasm and fatty content (sebaceous differentiation).
Oncocytoma of caruncle
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3. Oncocytoma of caruncle is a rare nesting tumor of the ocular surface arising in accessory lacrimal glands of caruncle. It is partially cystic and harbors bland epithelial cells with exclusive oncocytic metaplasia. It follows a benign clinical course and surgical excision is curative.
Melanocytoma of optic nerve low power
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4. Melanocytoma of optic nerve head is composed of polyhedral cells with low nuclear cytoplasmic ratio, smoothly contoured nuclei devoid of mitotic activity, and usually heavily pigmented cytoplasm. The neoplasm is ill demarcated showing feathering edges mimicking invasion (seen here spilling into neighboring optic nerve). It does not have metastatic potential and can be treated by surgery.
Normal iris A
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5. Normal iris and lens: the image shows pupillary zone of iris displaying anterior border layer, minimally pigmented iris stroma, anterior pigment epithelium with smooth muscle fibers of dilator muscle, and completely pigmented posterior pigment epithelium. Pupillary border of iris shows the sphincter muscle in stroma responsible for pupillary constriction. The lower aspect of image reveals anterior face of normal lens with externally placed lens capsule and internal lens epithelium.
Incarcerated iris in perforated corneal wound
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6. Incarcerated iris in perforated corneal wound in this image shows crater like corneal perforation borders with central incarcerated iris obstructing the wound and burgeoning to the external ocular surface. Complete disorganization of anterior chamber elements is readily identifiable.