Histopathology of Ocular Trauma

Question 1

What is a closed injury?

Answer 1

Commonly due to a blunt trauma, resulting in bruising and tearing of brain tissue and blood vessels.
- corneoscleral wall intact

Question 2

What is an open injury?

Answer 2

Involves a full thickness wound of the corneoscleral wall

Question 3

What is a contusion?

Answer 3

A closed injury resulting from a blunt trauma

Question 4

What is a rupture?

Answer 4

Full thickness wound caused by blunt trauma
- globe gives way at its weakest point , which may not be the site of impact

Question 5

What is a penetrating trauma?

Answer 5

Projectile enters and tears but does not pass through the tissue

Question 6

What is perforating trauma?

Answer 6

When there is an entrance and exit site

Question 7

What is the conjunctival laceration?

Answer 7

• When the tissue is torn or split revealing the bare sclera beneath
• Can be indicative of ocular penetration or perforation and can show signs of inflammation

Question 8

What does the later healing process involve?

Answer 8

This involved epithelial migration, myofibroblasts differentiation and collagen synthesis

Question 9

What are foreign body complications?

Answer 9

• Residual FB may cause an inflammatory reaction
• Residual foreign bodies may ionise and diffuse through ocular structures
• Siderosis (iron deposition) can occur in cornea, lens, iris stroma etc…
• Granulomatous inflammation
• Endophthalmitis

Question 10

What are the three stages of repair?

Answer 10

• Epithelial cell migration
• epithelial cell proliferation
• epithelial cell differentiation

Question 11

What happens during acid burns?

Answer 11

• Destruction of surface epithelium

Question 12

What are alkaline chemical burns?

Answer 12

• Destruction of surface epithelium
  Immediate epithelial swelling
  widespread necrosis of cornea and conjunctiva

Question 13

What is involved in thermal burns?

Answer 13

They mostly involve eyelids and face, but the surface of the cornea may be burnt resulting in corneal scarring

can be treated with topical antibiotic drops for about a week with topical steroids and cycloplegics

Question 14

What are the most likely sites of postoperative inflammation?

Answer 14

• point of surgical incision
• corneal endothelium
• stroma of the iris/ciliary body
• trabecular meshwork
• lens epithelium
• vitreous
• retinal tissue