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Eye tissue biopsy - Medium 1-3 cm
Biopsy
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No Fasting Required
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Biopsy of ocular tissue.
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Eye Tissue Biopsy - Medium 1-3 cm
- Why is it done?
- To obtain tissue samples from the eye or periocular structures for microscopic examination and histopathological analysis to diagnose various ocular conditions
- Primary indications include: suspicious conjunctival lesions, eyelid tumors or masses, corneal abnormalities, orbital lesions, and pterygium evaluation
- To differentiate between benign and malignant lesions, identify infectious agents, confirm inflammatory conditions, and guide treatment planning
- Performed when imaging studies are inconclusive or when definitive tissue diagnosis is required for clinical management decisions
- Medium-sized biopsies (1-3 cm) are appropriate for lesions that require adequate tissue sampling for comprehensive histological evaluation
- Normal Range
- Normal findings: Benign tissue architecture without evidence of malignancy, inflammation, or infection; intact epithelial layers; normal cellular morphology
- Expected results may vary based on biopsy site: conjunctival tissue shows normal squamous epithelium; eyelid tissue demonstrates hair follicles and sebaceous glands; corneal samples show normal stratified epithelium
- Negative result: Absence of tumor cells, absence of pathogenic organisms, no significant inflammatory infiltrate, normal collagen and elastic fiber arrangement
- Interpretation units: Qualitative histopathological assessment using standard microscopic grading and diagnostic classification
- No measurable numerical values; results reported as diagnostic impressions based on tissue characteristics, immunohistochemical staining, and cellular morphology
- Interpretation
- Benign findings: Pterygium, nevus, epidermoid inclusion cyst, dermoid cyst, or other benign lesions require observation or surgical removal for cosmetic/functional purposes only
- Malignant findings: Basal cell carcinoma, squamous cell carcinoma, melanoma, or lymphoma require urgent oncologic consultation and aggressive treatment planning
- Infectious agents: Positive cultures or identified organisms (bacterial, fungal, viral, parasitic) guide antimicrobial therapy selection and infection control measures
- Inflammatory conditions: Lymphocytic infiltration, granulomatous changes, or vasculitis patterns indicate underlying systemic or local inflammatory diseases
- Immunohistochemical staining patterns aid in precise tumor classification, determining prognosis, and identifying therapeutic targets
- Factors affecting interpretation: tissue quality, adequacy of sampling, fixation method, presence of necrosis, and crush artifact during specimen collection
- Dysplastic changes or carcinoma in situ indicate pre-malignant conditions requiring close surveillance and possible additional treatment
- Associated Organs
- Primary organ system: Eye and periocular structures including conjunctiva, cornea, sclera, eyelids, lacrimal gland, and orbital tissues
- Common benign conditions: Pterygium, pinguecula, episcleritis, scleritis, chalazion, and allergic conjunctivitis showing characteristic tissue findings
- Malignant neoplasms: Squamous cell carcinoma, basal cell carcinoma, sebaceous gland carcinoma, melanoma, and lymphoma of ocular tissues
- Infectious diseases: Viral keratitis (HSV, VZV), fungal infections (Aspergillus, Candida), bacterial infections, and parasitic infestations affecting ocular tissues
- Systemic associations: Ocular manifestations of sarcoidosis, tuberculosis, syphilis, lymphoma, metastatic disease, and autoimmune conditions
- Potential complications: Hemorrhage, infection, corneal scarring, visual impairment, globe perforation (rare with appropriate technique), and tissue necrosis
- Long-term implications: Malignant diagnoses require oncologic surveillance, potential metastatic evaluation, and systemic treatment consideration
- Follow-up Tests
- For malignant diagnoses: Staging imaging (CT, MRI, or PET scan) to assess metastatic disease; systemic evaluation including chest X-ray and laboratory workup
- Molecular and genetic testing: Flow cytometry for lymphomas, genetic mutation analysis (BRAF, KIT) for melanomas, and HPV testing for squamous lesions
- Infectious disease workup: Culture and sensitivity testing, additional molecular PCR testing, and specialized stains (GMS for fungi, AFB for mycobacteria)
- Systemic disease evaluation: ACE levels and chest imaging for sarcoidosis; serologic testing for syphilis, tuberculosis, and HIV if indicated
- Surveillance protocols: Regular ophthalmologic examinations every 3-6 months for benign lesions; quarterly or more frequent assessments for malignancies
- Repeat biopsy: May be indicated if diagnostic uncertainty remains, lesion recurs after treatment, or clinical changes occur during follow-up
- Complementary imaging: Ultrasound biomicroscopy (UBM), optical coherence tomography (OCT), anterior segment OCT, or B-scan ultrasound for detailed anatomic assessment
- Oncology referral for malignancies; infectious disease consultation for confirmed infections; immunology evaluation for inflammatory conditions
- Fasting Required?
- Fasting required: No - Eye tissue biopsy is a localized surgical procedure not requiring fasting unless general anesthesia is planned
- If general anesthesia: NPO (nothing by mouth) for 6-8 hours prior to procedure; typical fasting guidelines include no solid food 6 hours and clear liquids up to 2 hours before
- Medications to avoid: Discontinue anticoagulants (warfarin, DOACs) 3-5 days prior if possible; continue aspirin unless specifically contraindicated by surgeon
- Topical medications: Discontinue contact lens wear at least 1 week before biopsy; continue prophylactic topical antibiotics if prescribed by ophthalmologist
- Patient preparation: Thorough eyelid and periocular skin cleansing with antiseptic solution (typically povidone-iodine or chlorhexidine) on day of procedure
- Special instructions: Arrange transportation for procedures under anesthesia; inform surgeon of all medications, allergies, and bleeding disorders
- Post-procedure care: Apply antibiotic ointment as directed; avoid eye rubbing for 1-2 weeks; shield eye at night to prevent trauma during healing
- Follow-up care: Return appointment in 1-2 weeks for suture removal and wound assessment; monitor for signs of infection, excessive discharge, or vision changes
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