Fairuz, dr, SpPA

PATOLOGI MATA

Anatomi dan Histologi

Kelopak mata (eyelids)
- Cutaneous dan conjunctival
- epitel gepeng berlapis dan epitel konjuntiva yang lebih
tipis
- kelenjar sebasea (Zeis n Meibom), kelenjar apokrin
(Moll) an kelenjar ekrin
Bola mata
- ocular globe, dan kelenjar air mata
- Konjungtiva, kornea, sklera, intraocular
tissue : iris, ciliar body, choroid, retina, lensa cairan
vitreous

KELOPAK MATA (EYELID)

Chalazion

Sebaceous glands of eyelid, either

meibomian glands (deep type) or Zeis
glands (superficial type)
A non-specific response to obstruction of
these sebaceous glands. Causes
include infection and tumor
Lipogranulomatous inflammation with
lipid drop-out spaces

Chalazion

KELENJAR AIR MATA

DACRYOCYSTITIS
Canaculitis
Dapat disebabkan karena proses infeksi di
jaringan sekitar seperti konjungtiva, hidung.
Purulen exudate
Kronis : penebalan dinding sal. Lacrimal
DACRYOLITHIASIS
Karena proses inflamatory

DACRYOADENITIS
All ages.
Lacrimal gland.
Chronic inflammatory cells infiltration.
May have follicles. May be
granulomatous. Sometimes may be
difficult to distinguish from lymphoma.

MIKULICZS disease
Chronic dacryoadenitis disertai
pembesaran kelenjar parotis dan
kelenjar liur lain.
Benign lymphoepithelial lesion
Bila disertai dengan kegagalan sekresi
kelnjar lacrimal dan conjunctival serta
keratokonjungtivitis sicca Sjogren
syndrome

Konjungtiva

Pinguecula

Degenerative process in subepithelial

connective tissue of bulbar conjunctiva
Probably related to sun exposure
Focal, yellowish-gray, raised mass
Elastotic degeneration of collagen in
substantia propria. Possibly foreign body giant
cell response (actinic granuloma). Calcification
may occur in older lesions. Check for dysplasia
or squamous carcinoma in overlying
epithelium. Rule out elastofibroma.

Pinguecula

Pterygium

Extend into the cornea

Microscopically usually some actinic
elastosis , variable amount of acute and
chronic inflammation and congestion of
blood vessels
More important lesion than the
pinguecula

TUMOR
Papilloma
Squamous cell carcinoma
Melanoma maligna

Keratoconus

Second or third most common indication for

keratoplasty.
Usually presents during adolescence.
Centers of corneas.
Early, thinning and asymmetric ectasia of corneal
stroma. Often surrounded by brown ring of iron deposit
(Fleischer's ring). Later, posterior stromal striae and
possibly endothelial rupture with stromal edema and
clouding.
Earliest light microscopic changes are discontinuities
of Bowman's layer, filled with either epithelial cells or
fibroblasts. Next, stromal thinning becomes obvious

Keratoconus

RETINOBLASTOMA

Most common intraocular neoplasm of

children
Usually presents between 16 months
and 2 years
Can be bilateral
About 1/3 familial (these have
disproportionate share of multifocal
cases). Autosomal dominant.

Sheets of neoplastic small round cells with

hyperchromatic nuclei, scant cytoplasm
and many mitoses. Usually extensive areas
of ischemic necrosis and calcification with
nuclear debris, sparing perivascular
regions. Rosettes helpful to strengthen
diagnosis but not always seen. Rosettes
occur as two types, Flexner-Winterstein
with small lumen and Homer-Wright
(neuroblastomatous) with central neuropil.

Malignant. Poor prognostic features

include poor differentiation (few
rosettes), multifocality, large size, optic
nerve and choroidal invasion and
vitreous seeding.

Retinoblastoma

Retinoblastoma