DZI20-170: Lens

From MGH Learn Pathology

Request type Study
Subspecialty Eye
Set MEEI Eye Pathology Collection
Topic Lens
Presenter Stagner, Anna M.,MD

Toggle columns: Diagnosis

Case Clinical history Requester Diagnosis
Case Clinical history Requester Diagnosis

Case 1

Blind eye with elevated intraocular pressure null Phthisi bulbi phacoantigenic glaucoma. Note the closed angle and peripheral anterior synechiae. The iris is pulled posteriorly by a retroiridial/cyclitic fibrous membrane. There is iris neovascularization. The lens is cataractous with early morgagnian changes and an anterior subcapsular cataract with epithelioid histiocytes surrouding the lens (phacoanalphyatic/phacoantigenic glaucoma). The retina is detached disorganized and gliotic with cholesterol clefts. There is fibrous and osseous metaplasia of the retinal pigment epithelium.

Case 2

Blind eye with elevated intraocular pressure Aja51 Phacomorphic glaucoma. Note the large globoid lens with mature cataractous changes including eosinophilic “Morgagnian” globules which is pushing the iris forward and markedly shallowing the anterior chamber. There are focal peripheral anterior synechiae but the angle remains partially open. There is also atopic atrophy (the optic nerve is hypercellular with thickened pial septae). Bullous keratopathy and calcium deposition (band keratopathy) are also present. Also note the changes consistent with prior retinal detachment and repair (extensive multifocal chorioretinal scarring with gliosis and disorganization of the retina and a scleral encircling band).