A Histopathologist’s Guide to Ocular Pathology
Ophthalmic pathology at autopsy can seem a daunting business to the uninitiated. However, it has much to offer scientifically and diagnostically once the initial fears are overcome. The procedures are no more difficult — once learned — than those in many other branches of pathology. As ever, the “secret” is in good preparation and thoughtful and careful execution of all of the technical procedures. Therefore I encourage you to consider working in this extremely interesting area of pathology.
The most important component of autopsy ophthalmic pathology practice remains that of ensuring that all appropriate permissions and informed consents have been obtained for taking and retaining tissues. It is vitally important that the family of the patient be fully consulted and informed about the procedures, that they can be reassured that the reasons for performing the procedures are valid, and that there is no possibility that their relative will be “mutilated” by the procedure. The pathologist’s role here is to ensure that family members can spend important time with their deceased relative after the procedures have taken place, should they wish.
Specialist ophthalmic pathologists are available for consultation in individual cases. Most of us are very happy to receive case material from other pathologists should they wish to refer it and obviously to provide feedback of the results to both pathologists and clinicians.
KeywordsOptic Nerve Blunt Trauma Physical Child Abuse Abusive Head Trauma Ocular Pathology
Unable to display preview. Download preview PDF.
- 2.Underwood JCE. Autopsies and clinical audit. In: Cotton DWK, Cross SS, editors. The hospital autopsy. Oxford: Butterworth-Heinemann, 1993:163–172.Google Scholar
- 3.The autopsy and audit. Report of the Joint Working Party of The Royal College of Pathologists, The Royal College of Physicians of London and The Royal College of Surgeons of England. London: The Royal College of Pathologists, 1991.Google Scholar
- 4.Spencer RC. The microbiology of the autopsy. In: Cotton DWK, Cross SS, editors. The hospital autopsy. Oxford: Butterworth-Heinemann, 1993:144–157.Google Scholar
- 11.Forrest ARW. Toxicological and biochemical analysis. In: Burton J, Rutty GN, editors The hospital autopsy. 2nd ed. London: Arnold, 2001:126–133.Google Scholar
- 15.Knight B. The coroner’s autopsy. A guide to non-criminal autopsies for the general pathologist. Edinburgh: Churchill Livingstone, 1983:16.Google Scholar
- 18.Sousa AP, Viera DN, Oliveira MMF, Marques EP, Monanto PV. Comparison between ethanol levels of vitreous humour on both eyes in the same individual. Proceedings of the XXXV Annual Meeting, The International Association of Forensic Toxicologists, Padova: Centre of Behavioural and Forensic Toxicology, University of Padova, 1997:574–578.Google Scholar
- 19.Adams JH, Murray MF. Atlas of post-mortem techniques in neuropathology. Cambridge: Cambridge University Press 1982.Google Scholar
- 22.Lee WR. Examination of the globe: technical aspects. In: Lee WR, editor. Ophthalmic histopathology. 2nd ed. London: Springer-Verlag, 2002:1–33.Google Scholar
- 23.Lowe DG, Jeffrey IJM. Central nervous system and eye. In: Lowe DG, Jeffrey IJM, editors. Macro techniques in diagnostic histopathology. Ipswich, UK: Wolfe Medical Publications, 1990:136–140.Google Scholar
- 24.Lee WR. Ophthalmic histopathology. 2nd ed. London: Springer-Verlag, 2002.Google Scholar
- 26.Eagle RC, Jr. Pathology. Photographic tips for the Opthalmic Pathology Laboratory. In: Wilson RP (ed). Yearbook of opthalmology 1997. Mosby Year Book Inc: St. Louis, 1997:341–354.Google Scholar
- 32.Levin A. Retinal haemorrhages and child abuse. In: David TJ, editor. Recent advances in paediatrics. Edinburgh: Churchill Livingstone, 2000:151–219.Google Scholar
- 33.Taylor D, Bonshek R, Carter N, et al. Child abuse and the eye. The Ophthalmology Child Abuse Working Party. Eye 1999;13 (pt 1): 3–10.Google Scholar
- 37.Mian SI, Azar DT, Colby K. Management of traumatic cataracts. In: Ray SK, Jakobiec FA, editors. Ocular Trauma Int Ophthalmol Clin 2002;42:23–31.Google Scholar
- 38.Duke-Elder S, Macfaul PA. Concussion effects on the lens and zonule. In: Duke-Elder S (ed). System of ophthalmology, vol. XIV, part 1, mechanical injuries. London: Henry Kimpton, 1972:121–142.Google Scholar
- 40.Hamill MB. Clinical evaluation. In: Shingleton BJ, Hersh PS, Kenyon KR, editors. Eye trauma. St. Louis: Mosby, 1991:3–40.Google Scholar
- 41.Duke-Elder S, Macfaul PA. Concussion changes in the vitreous. In: Duke-Elder S (ed). System of ophthalmology, vol XIV, part 1, mechanical injuries. London: Henry Kimpton, 1972:194–198.Google Scholar
- 46.Cross SS. Autopsies, the deceased’s relatives and the law. In: Cotton DWK, Cross SS, editors. The hospital autopsy. Oxford: Butterworth-Heinemann, 1993:8–14.Google Scholar
- 47.Human Tissue Act, 1961 s.1.Google Scholar
- 48.Guidelines for the retention of tissues and organs at post-mortem examination. London: The Royal College of Pathologists, 2000.Google Scholar
- 49.Corneal Tissue Act, 1986 s.1.Google Scholar
- 50.National Health Service and Community Care Act 1990, Sched.9.Google Scholar
- 51.Consensus statement of recommended policies for uses of human tissue in research education and quality control. London: Royal College of Pathologists, 1999.Google Scholar
- 52.Harris DM. Biological safety. In: Cotton DWK, Cross SS, editors. The hospital autopsy. Oxford: Butterworth-Heinemann, 1993:15–31.Google Scholar
- 54.Advisory Committee on Dangerous Pathogens. Precautions for work with human and animal transmissible spongiform encephalopathies. Second impression. London: HMSO, 1994.Google Scholar
- 55.Advisory Committee on Dangerous Pathogens. Anatomy procedures on donor bodies suspected to have had, or to have been at risk of developing, Creutzfeldt-Jakob disease (CJD) or Gerstmann-Straussler-Scheinker Syndrome (GSS). Department of Health Circular PL(92)CO/4. London: Department of Health, 1994.Google Scholar
- 1.Farr R, Wheeler P, Parsons MA. The Sheffield Head Photographic Protocol . Available from: http://www.shef.ac.uk/shpp.Google Scholar