The Posterior Part of the Eye Only

Occasionally it is possible to obtain permission to remove only the posterior part of the eye, leaving the cornea, anterior chamber, and the iris-lens diaphragm undisturbed. The obvious reason is that the eye is left cosmetically normal for viewing by relatives, while important macular or retinal disease can be investigated by the pathologist. However, I advise that the eye be removed intact using other methods, if at all possible.

This method has been used in autopsies involving infants or children, when a good cosmetic result is particularly important. However, if there is the remotest possibility of nonaccidental injury, the transverse cut across the equator of the eye will either disrupt or leave behind (with the retained anterior half of the eye) peripheral retinal hemorrhages and focal areas of retinal detachment, which may be the earliest and/or the most characteristic diagnostic features of the shaken baby.10 Therefore I advise that both eyes and orbital contents be removed and fixed intact in any such case and in any death of uncertain cause involving the central nervous system in children.

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