15 - Pathology of the Conjunctiva, Orbit, Lacrimal Gland, and Intraocular Tumors

Abstract

A large array of pathologies must be considered in the etiologic differential diagnosis of diseases affecting the ocular tissues. Understanding the most common pathologies that explain symptoms in the eye or threaten life or vision even without symptoms, knowledge of the nomenclature and its nuances used to communicate findings, and recognizing challenging differential diagnoses are key to the accurate diagnosis and treatment of ocular diseases. This chapter describes the major causes of neoplastic ocular diseases, the histopathological findings, and major differential diagnoses. This chapter is divided into three sections. The first section describes the most common benign and malignant pathologies of the conjunctiva, some of which may be challenging lesions encountered in surgical pathology practice. The second section is dedicated to pathological processes affecting the orbital tissues and lacrimal gland, providing an overview of the most common diagnoses, the differential diagnoses, and options of treatment for mass lesions that may lead to decreased vision or worse. The third section describes the most common intraocular tumors including metastasis, uveal melanoma, and retinoblastoma. A discussion on the normal histopathology of the ocular tissues in each section will allow the reader to better understand the various pathological processes. The goal of the chapter is to determine the role of pathology in informing treatment strategies for eye diseases, and to illuminate the collaboration between the pathologist and ophthalmologist.