Ophthalmic pathologists are a heterogeneous group of sub-specialists who have dedicated all or part of their medical practice to the pathological analysis of tissues from the eye and ocular adnexa (conjunctiva, eyelid, lacrimal system, and orbit). There is no established training pathway for ophthalmic pathology and no board certification in ophthalmic pathology. The majority of ophthalmic pathologists are board-certified ophthalmologists who have additional fellowship training in ophthalmic pathology. A slightly smaller group includes board-certified pathologists with additional fellowship training in ophthalmic pathology. The smallest group consists of those who are board-certified in both ophthalmology and pathology. A minimum of one year of fellowship training in ophthalmic pathology is necessary to meet the criteria for ophthalmic pathologists.

The American Association of Ophthalmic Pathologists—an organization with more than 100 members—represents ophthalmic pathologists throughout the U.S. The work of ophthalmic pathologists varies depending on the setting in which they practice. Most are located at or associated with an academic center or teaching hospital with an ophthalmology training program. Their pathology practice may be in an independent laboratory or in a division of the pathology department. Most ophthalmic pathologists also have some clinical and/or basic science research interests in the field of ophthalmic pathology and related areas of ophthalmology. Having training in both ophthalmology and pathology provides the ophthalmologist with unique advantages in the diagnosis and study of ocular tissues.

The ophthalmic pathologist plays a particularly important role as teacher for residents in ophthalmology programs and, in some cases, pathology programs. The Ophthalmology Residency Review Committee and the American Board of Ophthalmology are committed to teaching residents ophthalmic pathology and have made study in this field a necessary requirement for completion of residency and board certification in ophthalmology.

The number of free-standing ophthalmic pathology laboratories in the U.S. is relatively small and has been shrinking with growing economic pressures on academic centers. The Department of Ophthalmology and Visual Sciences at the UI Roy J. and Lucille A. Carver College of Medicine is proud to have an independent ophthalmic pathology laboratory that serves University of Iowa Hospitals & Clinics and the state of Iowa. The F. C. Blodi Eye Pathology Laboratory is staffed with two ophthalmic pathologists. Both physicians are involved in the education of residents in ophthalmology and pathology as well as medical students.

How can the ophthalmic pathology laboratory be of use to your clinical practice? The F.C. Blodi Eye Pathology Laboratory is physically located at the Medical Research Center building in the Carver College of Medicine. The laboratory is fully certified and accredited by the College of American Pathologists as an anatomic pathology laboratory. The laboratory makes gross and microscopic examination of surgical pathology specimens from the eye and ocular adnexa and from autopsy eyes. It is fully equipped to process and section histological specimens and to do special histologic stains. Immunohistochemical stains are available as well.

The lab does a limited amount of cytology, including examination of vitreous and aqueous humor specimens. A detailed surgical pathology report is issued on every specimen sent to the ophthalmic pathology department. Although most specimens are read within two working days, some may take up to a week due to prolonged fixation or preparation time. The laboratory receives ocular specimens for consultation from ophthalmologists throughout the country and even from foreign countries.

Since a variety of unusual and unique disease processes may affect the eye and surrounding tissues, the ophthalmic pathology lab may be of particular help to other pathology labs that may not have expertise in examining the eye and eye tissues, such as the cornea, conjunctiva, and orbital lesions. The lab can be helpful in trying to make a difficult or unfamiliar diagnosis. Examples of such cases include intraocular tumors, such as retinoblastoma and uveal melanoma, glaucoma, conjunctival pigmented lesions, vitreous large cell lymphoma, and sebaceous cell carcinoma of the eyelid, to name a few. The ophthalmic pathology lab can be helpful in both the gross and microscopic preparation of tissue that may need special handling, such as eyes and corneas. Consultation or second opinions on difficult cases are available as well. The laboratory has an archive of tissues that dates back to the mid-1960s and is a valuable resource for research projects and clinicopathologic correlation.