Yale Ophthalmic Pathology

Ophthalmic Pathology

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The Ophthalmic Pathology Service provides diagnostic services to the Yale Department of Ophthalmology and Visual Sciences as well as community ophthalmologists and other hospitals in the area. We evaluate the broad range of specimens received from in and around the eye, including the skin of the eyelid, the conjunctiva, the cornea, the orbit, and the globe (eyeball). This includes both inflammatory and neoplastic lesions.

Ophthalmic Pathology Service

The eye includes a number of unique structures, with unique manifestations of disease and some diseases that do not occur elsewhere in the body. Ophthalmologists also have a specialized vocabulary, and require some specialized diagnostic services. The Yale Medical School Department of Pathology has responded to the unique needs of ophthalmologists by developing a specialty service in Ophthalmic Pathology. This service is headed by John Sinard, MD, PhD, who, in addition to being a board certified anatomic pathologist, also holds a joint appointment in the Yale Department of Ophthalmology and Visual Sciences. For many of the lesions that are unique to the eye, such as corneal or conjunctival lesions, or lesions that involve the eye itself, an ophthalmic pathologist will be more familiar with the spectrum of diseases, the histological appearance, and the appropriate terminology to more accurately communicate the findings to the ophthalmologist.
Services and Expertise
Specimens received by Yale Pathology from ophthalmologists are routinely routed to the Ophthalmic Pathology Service, where they are evaluated by a pathologist with subspecialty expertise in ophthalmic pathology. The eye and its surrounding structures (eyelids, orbit) represent a unique portion of the human anatomy. The eye itself is a complex structure, composed of specialized “layers” of tissue, each with a specific histology and function. More than simply a specialized sense organ, the eye is a direct extension of the central nervous system and is the source of more sensory input to the brain than any other organ or tissue. To accomplish its unique purpose, many of the “standard” rules of histology do not apply in the eye. For example, the cornea is avascular, the anterior surface of the iris lacks an epithelial lining, and the interior of the eye represents an immunologically privileged site. These unique characteristics result in the eye responding differently to injury and disease than do other parts of the body, and, in fact, different portions of the eye can respond very differently to the same type of injury. The Ophthalmic Pathology Service exists to address these unique needs of the ophthalmology community. We receive specimens from the Yale Department of Ophthalmology and Visual Sciences, community ophthalmologists, the West Haven VA, Bridgeport Hospital, and other local hospitals, as well as consultation material from other states.

Yale Ophthalmic Pathology

Director

Bio Profile

John H. Sinard, MD, PhD

Director

Professor of Pathology and of Ophthalmology and Visual Science

Vice Chair Pathology

Director, Anatomic Pathology

Medical Director, Pathology Informatics

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Pathologists

Publications :
  • Gloor P, Ansari I, Sinard J.  Sebaceous carcinoma presenting as a unilateral papillary conjunctivitis.  Am. J. Ophthalmol.  1999 Apr; 127(4): 458-459.
  • Meyer D., Ge J, Blinder KJ, Sinard J, Xu S.  Malignant transformation of an optic disk melanocytoma.  Am. J. Ophthalmol.  1999 Jun; 127(6): 710-714.
  • Diaz V, DeBroff BM, Sinard J.  Comparison of histopathologic features, clinical symptoms, and erythrocyte sedimentation rates in biopsy-positive temporal arteritis.  Ophthalmology.  2005 Jul; 112(7): 1293-1298.  PMID: 15921755
  • Lu F, Hu Z, Sinard J, Garen A, Adelman RA.  Factor VII-verteporfin for Targeted Photodynamic Therapy in a Rat Model of Choroidal Neovascularization.  Invest Ophthalmol Vis Sci.  2009 Aug; 50(8): 3890-3896. [EPub 2009 Apr 8].  PMID: 19357351
  • Servat JJ, Williamson JE, Piepmeier J, Sinard J, Bernardino CR.  Giant myofibroma of the orbit in an adult male.  Orbit.  2012 Feb; 31(1): 21-23. [Epub 2011 Oct 18].  PMID: 22007896
  • Mohsenin A, Sinard J, Huang JJ.  Necrobiotic xanthogranuloma and chronic lymphocytic leukemia of the conjunctiva masquerading as scleritis and uveitis.  Clinical Ophthalmology.  2012 Dec 13; 6: 2045-2047.  PMID: 23271884
  • Salchow DJ, Sinard J.  Management of lens dislocation and iris cyst after iris-sutured intraocular lens implantation in children with Marfan syndrome.  J. Pediatric Ophth and Strabismus.  2013 Feb 26; 30: e8-10.  PMID: 23429576
  • Oats J, Zhang Z, Tseng H, Shields MB, Sinard JH, Loewen NA.  In vitro and in vivo comparison of two suprachoroidal shunts. Invest Ophthalmol Vis Sci.  2013 Aug 13; 54(8): 5416-5423 [EPub 2013 Jul 11]. PMID: 23847318
  • Gaudio P, Sinard J, Shield D, Huang J, King B.  Repeat conjunctival biopsy after immunomodulatory therapy for ocular mucous membrane pemphigoid.  Ocular Immunol and Inflamm.  (Epub ahead of print) [EPub 2016 Jul 20]  PMID: 27437791
  • Tainsh LT, Coady PA, Sinard JH, Neparidze N, Meskin SW, Adelman RA, Chow J.  Asymmetric deep stromal keratopathy in a patient with multiple myeloma.  Cornea.  2017 Mar; 36(3): 372-374.  PMID: 28079685.
  • Kim J, Hall L, Elia M, Ehrlich M, Materin M, Sinard J.  Acute presentation of mesectodermal leiomyoma of the ciliary body.  Ocular Oncology and Pathology.  2017 Apr; 3(4): 304-309. [Epub 2017 Apr 21].
The Program in Ophthalmic Pathology responsible for educating both the pathology residents and the ophthalmology residents in ophthalmic pathology. For pathology residents, this is done via daily signouts and subspecialty conferences. For the ophthalmology residents, education in ophthalmic pathology takes the form of a monthly lecture/conference series for all of the residents, as well as weekly one-on-one meetings with an ophthalmic pathologist for the resident on the oculoplastics and pathology rotation.