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By G. O. H. Naumann M.D., D. J. Apple M.D. (auth.)

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A large study regarding the incidence of eyelid biopsies has been carried out and was described in detail in Apple and Rabb 2 (see Chapter 15). Naumann and Portwich33 separated the biopsy specimens received in their laboratory from a collection of 1000 enucleated globes accessioned over a several-year period in order to analyze the various disease processes found in these eyes. They then correlated these data with the clinical histories of each case, thereby determining a relationship between the various causes or reasons for enucleation and the final pathologic processes as determined by histopathologic examination.

Modified from Apple and Rabb: Ocular Pathology, Clinical Applications and Self-Assessment, ed. 3. Mosby, St. Louis, 1985). 13 Gross Examination and Histologic Techniques TABLE 1-6. Orientation of the Globe in Histologic Sections A. Criteria for horizontal sections I. Pinguecula 2. The ciliary body is larger nasally than temporally. 3. Peripheral microcystoid degeneration of the retina is greater and more widespread temporally than nasally. 4. The macular region is included; the ganglion cell layer is multilayered.

There is a slight difference in the distance of the rectus muscles from the limbus (spiral of Tillaux) (Fig. 1-9), but this difference is usually too subtle for orientation at the gross level. Fixation, Sectioning, and Preparation of Histologic Sections Good fixation of the enucleated globe is important for adequate pathologic examination. 27 Good results can be obtained by using buffered Sup. Moo. Inf. 1-9. Spiral ofTillaux, delineating the distance of the insertions of the rectus muscles from the limbus.

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