Ophthalmic Pathology Branch of NP Service 2.

 

Overview. The NP fellow will participate fully in all aspects of the diagnostic and educational Ophthalmic Pathology service during protected blocks of time on Tuesday and Thursday afternoons for at least 6 months. This includes ~275-300 PUH/Eye and Ear cases and ~35 consults from tri-state area adult and pediatric hospitals and the coroners office. The fellow will be responsible for the smooth operation of the service, coordinating with the ophthalmology resident on the service to obtain relevant clinical information, and participating in weekly reading assignments and topic based quizzes. By the end of the rotation, the fellow will be able to confidently handle common eye path specimens and generate final reports with appropriate diagnoses, comments, gross and microscopic descriptions, and tissue/billing codes.

 

Goals for NP fellows.

 

Learn to identify, orient, and systematically examine enucleation specimens, with emphasis on selecting appropriate plane of section for neoplastic, traumatic/forensic, and phthisical eyes.

 

Learn importance of clinician-pathologist and pathologist-histotechnician communication, particularly with regard to achieving proper orientation of corneal and conjunctival biopsies..

 

Gain familiarity with normal appearance of ocular structures submitted to pathology.

 

Be able to distinguish common pathologic responses in the eye that disrupt visual function from incidental age-related changes.

 

Identify diagnostic features of Fuchs’ dystrophy and keratoconus.

 

Be able to discuss endothelial, inflammatory, and pressure-related causes of bullous keratopathy.

 

Be able to differentiate artifactual from true retinal detachment.

 

Learn natural history of ocular vs. conjunctival melanomas, and how to evaluate and report pigmented lesions of the eye with an understanding of the pertinent prognostic issues.

 

Know the most pertinent margin to examine in retinoblastoma enucleations, and be able to list common clinical mimics

 

Learn to recognize pathologic sequelae of diabetes, end-stage glaucoma, and penetrating/perforating trauma.

 

Be able to list the characteristic anterior segment, posterior segment, and optic nerve lesions associated with child abuse, and to discuss non-traumatic medical conditions (if any) that can lead to similar findings.