Definition and Overview

An ocular pathology follow-up is an appointment with an ophthalmologic surgeon following the surgery and examination of eye tissues by a pathologist.

Also referred to as ophthalmic pathology, ocular pathology is one of the many specialties under surgical pathology, which refers to the in-depth study of the components of a tissue or a fluid to confirm the presence or absence of a disease. The process of removing tissue for a study is called biopsy (a precise sharp instrument is used to lift a part of the tissue) or aspiration (a needle attached to a syringe is inserted to extract fluid from the affected part of the eye). Both are performed under local anaesthesia to minimise pain and discomfort.

Using the obtained samples, the pathologist will then conduct a thorough examination, taking note of any changes in the tissue structure, the presence of abnormal or suspicious cells, and damage to the tissues, which can confirm the presence or absence of a disease.

Pathologists are expected to work closely with an ophthalmologist, who interprets the results and discusses them with the patient. It’s important to note that the study is just a part of making a diagnosis. The ophthalmologist will consider other factors including age, predisposition to certain risks affecting the eyes, and preexisting illness before he makes a definite diagnosis.

Who Should Undergo and Expected Results

An ocular pathology follow-up is important for those who have undergone a surgical biopsy, which is a procedure performed to obtain tissue sample during the surgery. As an example, a patient who has a growing eye tumour typically undergoes surgery to relieve pressure in the eyes. In the process, the tumour tissue is removed and sent to the lab for further analysis. A pathologist will then determine whether the tumour cells are malignant or benign.

The follow-up is also recommended for those who are suffering from progressive eye diseases such as glaucoma, which is characterised by the gradual deterioration of the optic nerves. Although treatment is not yet available, the damage may be slowed down by relieving intraocular pressure. The pathological study may be helpful in understanding the extent of the damage while the follow-up care is needed to monitor how the illness is progressing.

Further, the follow-up is ideal to keep track of the patient’s recovery from the surgery and biopsy, taking note of any emergence of complications that can delay healing or cause undue damage to the rest of the eyes and vision.

How Does the Procedure Work?

The ocular pathology follow-up care is discussed by the surgeon to the patient prior to the surgical procedure. This is because the process is an integral part of the patient’s overall follow-up plan, wherein every aspect of post-surgery, including the patient’s resumption of normal routines, is considered.

This is also to begin conditioning the patient that appointments are also required and necessary even after the surgery is completed, more so if a biopsy has been conducted.

The follow-up starts as soon as the surgery is over and after the patient has been discharged from the hospital. The pathological results can be discussed even when the patient is already out of the hospital.

The initial follow-up is often long, running for about an hour or more. It’s expected that the patient will ask a series of questions or discuss his concerns. Depending on the result, the ophthalmologist may request for more tests or give a diagnosis and a treatment plan, if necessary and relevant.

The frequency of the follow-up varies. In some cases, once could be enough. In other cases, a visit may be necessary every week for a month or two.

Possible Risks and Complications

Many people are having a hard time adhering to follow-up care. In a study conducted on glaucoma patients in a Philadelphia hospital, they discovered that only 25% of those who need follow-up proceeded with their appointments. The said research also outlined some of the common reasons for the failure. These include not seeing their doctor for at least a year and forgetting about the recommendation. The usual waiting time between the biopsy and the release of the result is around five days, which can be too long for others.

The staff should personally remind patients of their appointments and ophthalmologist should be able to stress the need to be religious with the follow-up care. They may also encourage patients to bring a loved one during these sessions if it lowers their anxiety.

References:

  • American Academy of Ophthalmology Preferred Practice Patterns Committee. Preferred Practice Pattern Guidelines. Comprehensive Adult Medical Eye Evaluation -- 2010.
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