Case Study: June 2010

History

A 75 year old woman presents with a painful eye.

Slit lamp examination reveals corneal oedema, a hypermature cataract and s deep anterior chamber. Gonioscopy shows an open angle.

An aqueous flush out is performed and the figures show the cytology of the aqueous wash out.

Questions

1. What do the figures demonstrate?

2. Which immunostain can be used to stain the cells in the figures?

3. Which tinctorial stain can be used to stain the cytoplasm of these cells?

4. What is the clinico-pathological diagnosis?

Click to show answers

Bubbly macrophages
CD68
PAS-will show PAS positive material lens protein in macrophage cytoplasm.
Phacolytic glaucoma (a.k.a. lens protein glaucoma). The trabecular meshwork is clogged with high molecular weight lens protein and macrophages that have taken up the protein.