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Eviscerations.

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Presentation on theme: "Eviscerations."— Presentation transcript:

1 Eviscerations

2 Why eviscerate? Scleral shell left behind –better cosmesis.
Indications: blind painful..painless / disfigured / not responding to treatment eye scenarios. Comprise of blood frags, corneo-scleral disc, retina and uveal tissue, lens (lens prosthesis), vitreous.

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4 What do you do with them? Examine all fragments. Bisect tissues
H&E, PAS, Perls +/- bug stains. Are there histological hallmarks of sympathetic ophthalmia. Any tumour? Any pathology that can inform how the other eye will do?

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6 Band keratopathy Dystrophic calcification

7 Acute inflammation

8 Chronic inflammation-chronic keratitis
Blood vessels Plasma cells

9 Infective agent-bacteria

10 Endothelial Cell Loss

11 Host-donor interface scar

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14 New vessels on anterior stromal surface

15 Ectropion uveae, secondary to rubeosis

16 Fig 8.23 Rubeotic glaucoma

17 Grossly thickened basement membrane of pars plicata

18 Brown pigment clogging trabecular meshwork

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28 Proliferative diabetic retinopathy Note new-vessels, surrounded
Fibrous tissue on retinal surface.

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30 Normal retinal arteriole

31 Arteriolosclerosis-note thick wall-called hyalinisation.
Hyalinisation due to accumulation of lipid and fibrin, from leaky vessel, due to pericyte death

32 Occluded branch venule. Note inflammation around vessel
-attempts at organisation of thrombus

33 Perl’s stain picks up haemosiderin Stains it intense blue.
This indicates previous intra-retinal haemorrhage from BRVO

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35 Hard druse. Pink, homogeneous nodular material
Lies between RPE basement membrane and inner collagenous part of Bruch’s. Note overlying RPE arophy

36 Fluffier, more diffuse, soft drusen
Thickened Bruch’s Fluffier, more diffuse, soft drusen

37 Thick Bruch’s, hard drusen and complete loss of photoreceptors

38 CNVM RPE RPE RETINA Haemorrhage of CNVM.
CNVM lies between neural retina And RPE Eventual organisation of haemorrhage Will lead to disciform scar. RPE choroid CNVM RPE RETINA

39 Vessel of CNVM CNVM choroid RPE

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41 Choriocapillaris intact
Granulomatous (non-caseating) inflammation of uvea (choroid in this case), sparing the choriocapillaries

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45 PRP SCAR

46 Loss of choriocapillaris Loss of RPE Bruch’s
Gliotic retina PRP SCAR-loss of RPE and choriocapillaris Retinochoroidal atrophy Retinal gliosis Gliotic retina in direct apposition to Bruch’s


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