Skip to main content

The Eye

  • Chapter
  • First Online:
Eye Pathology

Abstract

The general pathologist may receive an eye for histopathological analysis for various reasons. This chapter presents the routine sectioning of eyes and the sequence in which findings are presented. Embryology, development and anatomy of the normal eye are presented. The various pathological congenital anomalies involving the entire globe are described. Inflammations and infections involving all layers of the eyeball are described, and the more severe traumatic lesions like phacoanaphylactic endophthalmitis are discussed. The negative end result of any disease involving an eye – phthisis – is described, and the chapter ends with a presentation of what a general pathologist may receive from the eye region after the eye has been removed, i.e. orbital implants and prostheses.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 129.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 169.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 249.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Lynnerup N, Kjeldsen H, Zweihoff R, Heegaard S, Jacobsen C, Heinemeier J. Ascertaining year of birth/age at death in forensic cases: a review of conventional methods and methods. Forensic Sci Int. 2010;201:74–8.

    Article  PubMed  Google Scholar 

  2. Hansen AB, Petersen C, Heegaard S, Prause JU. Review of 1028 bulbar eviscerations and enucleations. Changes in aetiology and frequency over a 20-year period. Acta Ophthalmol Scand. 1999;77:331–5.

    Article  CAS  PubMed  Google Scholar 

  3. Mann I. Developmental abnormalities of the eye. 2nd ed. London: BMA; 1957. p. 1–419.

    Google Scholar 

  4. American Academy of Ophthalmology. Chapter 5. Ocular development. In: Fundamentals and principles of ophthalmology. San Francisco: AAO; 2007–2008. p. 123–58.

    Google Scholar 

  5. Forrester J, Dick A, McMenamin P, Lee W. The eye. Basic sciences in practice. Chapter 2, embryology and early development of the eye and adnexa. London: W B Saunders; 1996. p. 87–116.

    Google Scholar 

  6. Graw J. Eye development. Curr Top Dev Biol. 2010;90:343–86.

    Article  PubMed  Google Scholar 

  7. Shaham O, Menuchin Y, Farhy C, Ashery-Padan R. Pax6: a multilevel-regulator of ocular development. Prog Retin Eye Res. 2012;31:351–76.

    Article  CAS  PubMed  Google Scholar 

  8. American Academy of Ophthalmology. Chapter 2. The eye. In: Fundamentals and principles of ophthalmology. San Francisco: AAO; 2007–2008. p. 43–89.

    Google Scholar 

  9. Forrester J, Dick A, McMenamin P, Lee W. The eye. Basic sciences in practice. Chapter 1, anatomy of the eye. London: W B Saunders; 1996. p. 1–86.

    Google Scholar 

  10. Dua HS, Faraj LA, Said DG, Gray T, Lowe J. Human corneal anatomy redefined: a novel pre-descemet’s layer (Dua’s layer). Ophthalmology. 2013. doi:10.1016/j.ophtha.2013.01.018. pii: S0161-6420(13)00020-1.

    PubMed Central  Google Scholar 

  11. Pruett RC. Aging changes. In: Albert DM, Jakobiec F, editors. Principles and practice of ophthalmology. Basic sciences. Philadelphia: WB Saunders; 1994. p. 683–748.

    Google Scholar 

  12. Slavotinek AM. Eye development genes and known syndromes. Mol Genet Metabol. 2011;104:448–56.

    Article  CAS  Google Scholar 

  13. Morrison D, Fitzpatrick D, Hanson I, Williamson K, van Heyningen V, Fleck B, Jones I, Chalmers J, Campbell H. National study of microphthalmia, anophthalmia, and coloboma (MAC) in Scotland: investigation of genetic aetiology. J Med Genet. 2002;39:16–22.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  14. Alyahya GA, Heegaard S, Fledelius HC, Rechnitzer C, Prause JU. Primitive neuroectodermal tumour of the orbit in a 5-year-old girl with microphthalmia. Graefe’s Arch Clin Exp Ophthalmol. 2000;238:801–6.

    Article  CAS  Google Scholar 

  15. Clementi M, Tenconi R, Bianchi F, Botto L, Calabro A, Calzolari E, Cianciulli D, Mammi I, Mastroiacovo P, Meli P, Spagnolo A, Turolla L, Volpato S. Congenital eye malformations: a descriptive epidemiologic study in about one million newborns in Italy. Birth Defects Orig Artic Ser. 1996;30:413–24.

    CAS  PubMed  Google Scholar 

  16. Warburg M, Jensen H, Prause JU, Bolund S, Skovby F, Miranda MJ. Anophthalmia-microphthalmia-oblique clefting syndrome: confirmation of the Fryns anophthalmia syndrome. Am J Med Genet. 1997;73:36–40.

    Article  CAS  PubMed  Google Scholar 

  17. Verma AS, FitzPatrick DR. Anophthalmia and microphthalmia. Orphanet J Rare Dis. 2007;26:47. doi:10.1186/1750-1172-2-47.

    Article  Google Scholar 

  18. Bakrania P, Robinson DO, Bunyan DJ, Salt A, Martin A, Crolla JA, Wyatt A, Fielder A, Ainsworth J, Moore A, Read S, Uddin J, Laws D, Pascuel-Salcedo D, Ayuso C, Allen L, Collin JR, Ragge NK. SOX2 anophthalmia syndrome: 12 new cases demonstrating broader phenotype and high frequency of large gene deletions. Br J Ophthalmol. 2007;91:1471–6.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  19. Chassainga N, Ragge N, Kariminejade A, Buffet A, Ghaderi-Sohie S, Martinovic J, Calvasa P. Mutation analysis of the STRA6 gene in isolated and non-isolated anophthalmia/microphthalmia. Clin Genet. 2013;83:244–50.

    Article  Google Scholar 

  20. Yahyavi M, Abouzeid H, Gawdat G, de Preux A-S, Xiao T, Bardakjian T, Schneider A, Choi A, Jorgenson E, Baier H, El Sada M, Schorderet DF, Slavotinek AM. ALDH1A3 loss of function causes bilateral anophthalmia/microphthalmia and hypoplasia of the optic nerve and optic chiasm. Hum Mol Genet. 2013;22:1–9. doi:10.1093/hmg/ddt179.

    Article  Google Scholar 

  21. Kara N, Baz O, Altinkaynak H, Altan C, Demirok A. Assessment of the anterior chamber angle in patients with nanophthalmos: an anterior segment optical coherence tomography study. Curr Eye Res. 2013;38:563–8.

    Article  PubMed  Google Scholar 

  22. Steijns D, Bijlsma WR, Van der Lelij A. Cataract surgery in patients with nanophthalmos. Ophthalmology. 2013;120:266–70.

    Article  PubMed  Google Scholar 

  23. Ehlers N. Cryptophthalmos with orbito-palpebral cyst and microphthalmos. Acta Ophthalmol. 1966;44:84–94.

    Article  CAS  Google Scholar 

  24. Porges Y, et al. Hereditary microphthalmia with colobomatous cyst. Am J Ophthalmol. 1992;114:30–4.

    Article  CAS  PubMed  Google Scholar 

  25. Andersen ST, Fledelius HC, Heegaard S, Prause JU. Bilateral microphthalmia with cyst. Acta Ophthalmol Scand. 2004;82:490–1.

    Article  PubMed  Google Scholar 

  26. Foxman S, Cameron JD. The clinical implications of bilateral microphthalmia with cyst. Am J Ophthalmol. 1984;97:632–8.

    Article  CAS  PubMed  Google Scholar 

  27. Perry LP, Jakobiec FA, Zakka FR, Walton DS. Newborn primary congenital glaucoma: histopathologic features of the anterior chamber filtration angle. J AAPOS. 2012;16:565–8.

    Article  PubMed  Google Scholar 

  28. Petry P, Polli JB, Mattos VF, Rosa RCM, Zen PRG, Graziadio C, Paskulin GA, Rosa RFM. Clinical features and prognosis of a sample of patients with trisomy 13 (Patau syndrome) from Brazil. Am J Med Genet. 2013;161A:1278–83.

    Article  PubMed  Google Scholar 

  29. Rasmussen MLR, Prause JU, Johnson M, Kamper-Jørgensen F, Toft PB. Review of 345 eye amputations carried out in the period 1996–2003, at Rigshospitalet, Denmark. Acta Ophthalmol. 2010;88:218–21.

    Article  PubMed  Google Scholar 

  30. Fan JC, Niederer RL, von Lany H, Polkinghorne PJ. Infectious endophthalmitis: clinical features, management and visual outcomes. Clin Exp Ophthalmol. 2008;36:631–6.

    Google Scholar 

  31. Guerra RLL, Freitas BP, Parcero CMFM, Júnior OOM, Marback RL. An outbreak of forty five cases of pseudomonas aeruginosa acute endophthalmitis after phacoemulsification. Arq Bras Oftalmol. 2012;75:344–7.

    Article  PubMed  Google Scholar 

  32. Goldberg RA, Flynn Jr HR, Isom RF, Miller D, Gomzalez S. An outbreak of streptococcus endophthalmitis after intravitreal injection of bevacizumab. Am J Ophthalmol. 2012;153:204–8.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  33. Margo CE, Mames RN, Guy JR. Endogenous klebsiella endophthalmitis. Report of two cases and review of the literature. Ophthalmology. 1994;95:1298–301.

    Article  Google Scholar 

  34. Durand ML. Endophthalmitis. Clin Microbiol Infect. 2013;19:227–34.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  35. Leng T, Miller D, Flynn HW, Jacobs DJ, Gedde SJ. Delayed-onset bleb-associated endophthalmitis(1996–2008) causative organisms and visual acuity outcomes. Retina. 2011;31:344–52.

    Article  PubMed  Google Scholar 

  36. Jacobs DJ, Leng T, Flynn Jr HW, Shi W, Miller D, Gedde SJ. Delayed-onset bleb-associated endophthalmitis: presentation and outcome by culture result. Clin Ophthalmol. 2011;5:739–44.

    Article  PubMed Central  PubMed  Google Scholar 

  37. Sugita S, Kamoi K, Ogawa M, Watanabe K, Shimizu N, Mochizuki M. Detection of Candida and Aspergillus species DNA using broad-range real-time PCR for fungal endophthalmitis. Graefes Arch Clin Exp Ophthalmol. 2012;250:391–8.

    Article  CAS  PubMed  Google Scholar 

  38. Chang PHY, Chodosh J. Diagnostic and therapeutic considerations in fungal keratitis. Int Ophthalmol Clin. 2011;51:33–42.

    Article  PubMed  Google Scholar 

  39. Jørgensen JS, Prause JU, Kiilgaard JF. Bilateral endogenous Fusarium solani endophthalmitis in a liver transplanted patient. J Med Case Re 2014;8(1):101. doi: 10.1186/1752-1947-8-101.

  40. Rasmussen MLR. The eye amputated. Consequences of eye amputation with emphasis on clinical aspects, phantom eye syndrome and quality of life. Acta Ophthalmol. 2010;88(thesis 2):1–25.

    Article  PubMed  Google Scholar 

  41. Ibanga A, Asana U, Nkanga D, Duke R, Etim B, Oworu O. Indications for eye removal in southern Nigeria. Int Ophthalmol. 2013;33:355–60.

    Article  PubMed  Google Scholar 

  42. Large MM, Nielssen OB. Self-enucleation: forget Freud and Oedipus, it’s all about untreated psychosis. Br J Ophthalmol. 2012;96:1056–7.

    Article  PubMed  Google Scholar 

  43. Wisse RPL, Bijlsma WR, Stilma JS. Ocular firework trauma: a systematic review on incidence, severity, outcome and prevention. Br J Ophthalmol. 2010;94:1586–91.

    Article  CAS  PubMed  Google Scholar 

  44. Agrawal R, Wei HS, Teoh S. Predictive factors for final outcome of severely traumatized eyes with no light perception. BMC Ophthalmol. 2012;12:16.

    Article  PubMed Central  PubMed  Google Scholar 

  45. Knyazer B, Bilenko N, Levy N, Lifshitz T, Belfair N, Klemperer I, Yagev R. Open globe eye injury characteristics and prognostic factors in Southern Israel: a retrospective epidemiologic review of 10-years-experience. Isr Med Assoc J. 2013;15:158–62.

    PubMed  Google Scholar 

  46. Lee WR. Ophthalmic pathology. 2nd ed. London: Springer; 2002. p. 1–475.

    Google Scholar 

  47. Levin AV. Retinal hemorrhage in abusive head trauma. Pediatrics. 2010;126:961–70.

    Article  PubMed  Google Scholar 

  48. Rohrbach M, Benz D, Friedrichs W, Thiel H-J, Wehner H-D. Ocular pathology of the battered-child syndrome. Klin Monatsbl Augenheilkd. 1997;210:133–8.

    Article  CAS  PubMed  Google Scholar 

  49. Chaithanya N, Devireddy SK, Kumar KRV, Gali RS, Aneja V. Sympathetic ophthalmia: a review of literature. Oral Surg Oral Med Oral Pathol Oral Radiol. 2012;113:172–6.

    Article  Google Scholar 

  50. Chu XK, Chan C-C. Sympathetic ophthalmia: to the twenty-first century and beyond. J Ophthal Inflamm Infect. 2013;3:49.

    Article  Google Scholar 

  51. Ozbek Z, Arikan G, Yaman A, Oner H, Bajin MS, Saatci AO. Sympathetic ophthalmia following vitreoretinal surgery. Int Ophthalmol. 2010;30:221–7.

    Article  PubMed  Google Scholar 

  52. Tseng VL, Matoso A, Hofmann RJ. Sympathetic ophthalmia following enucleation. Graefes Arch Clin Exp Ophthalmol. 2013;251:393–4.

    Article  PubMed  Google Scholar 

  53. Marak GE. Phacoanaphylactic endophthalmitis. Surv Ophthalmol. 1992;36:325–39.

    Article  PubMed  Google Scholar 

  54. Thach AB, Marak GE, McLean IW, Green WR. Phacoanaphylactic endophthalmitis: a clinicopathological review. Int Ophthalmol. 1991;15:271–9.

    Article  CAS  PubMed  Google Scholar 

  55. Tanito M, Kaidzu S, Katsube T, Nonoyama S, Takai Y, Ohira A. Diagnostic western blot for lens-specific proteins in aqueous fluid after traumatic lens-induced uveitis. Jpn J Ophthalmol. 2009;53:436–9.

    Article  PubMed  Google Scholar 

  56. Jordan DR, Brownstein S, Faraji H. Clinicopathological analysis of 15 explanted hydroxyapatite implants. Ophthal Plast Reconstr Surg. 2004;20:285–90.

    Article  PubMed  Google Scholar 

  57. Yoon JS, Lew H, Kim SJ, Lee SY. Exposure rate of hydroxyapatite orbital implants: a 15-year experience of 802 cases. Ophthalmology. 2008;115:566–72.

    Article  PubMed  Google Scholar 

  58. Blaydon SM, Shepler TR, Neuhaus RW, White WL, Shore JW. The porous polyethylene (Medpor) spherical orbital implant. A retrospective study of 136 cases. Ophthal Plast Reconst Surg. 2003;19:364–71.

    Article  Google Scholar 

  59. Chuo JY, Dolman PJ MD, Ng TL, Buffam FV MD, White VA. Clinical and histopathologic review of 18 explanted porous polyethylene orbital implants. Ophthalmology. 2009;116:349–54.

    Article  PubMed  Google Scholar 

  60. Karslıoğlu S, Buttanrı IB, KorhanFazıl K, Serin D, Akbaba M. Long-term outcomes of pegged and unpegged bioceramic orbital implants. Ophthal Plast Reconstr Surg. 2012;28:264–7.

    Article  PubMed  Google Scholar 

  61. Shevchenko L, Boss J, Shah CT, Droste PJ, Hassan AS. Alphasphere as a successful ocular implant in primary enucleation and secondary orbital implant exchange. Orbit. 2013;32:161–5.

    Article  PubMed  Google Scholar 

  62. Jordan DR. Hydroxyapatite implants. Ophthalmology. 2008;115:2320–1.

    Article  PubMed  Google Scholar 

  63. Oestreicher JH. Hydroxyapatite orbital implants. Ophthalmology. 2008;115:2096.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Jan Ulrik Prause MD, DMSc, DHC, FEBO .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2015 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Prause, J.U., Saornil, M.A. (2015). The Eye. In: Heegaard, S., Grossniklaus, H. (eds) Eye Pathology. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-43382-9_1

Download citation

  • DOI: https://doi.org/10.1007/978-3-662-43382-9_1

  • Published:

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-662-43381-2

  • Online ISBN: 978-3-662-43382-9

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics