Fig. 76. Cholesterolosis of the eye following trauma. A. The extravasated blood of a vitreous hemorrhage has degraded to cholesterol crystals (synchysis scintillans). The vitreous has herniated through the pupil in this aphakic enucleated eye. B. Within the delicate displaced vitreous framework, the negative image of cholesterol can be identified. The process of tissue preparation has dissolved the cholesterol itself. (Wilder reticulum stain; × 40.) C. The crystals can be seen by special preparations not involving solvents, such as this “smear” preparation. (× 40.) D. Before processing, the cholesterol crystals have a birefringent character. (Polarized; × 101.) E. In the choroid, there is a granulomatous foreign body reaction to cholesterol, represented in this section by “cholesterol clefts.” The process of degradation of blood is usually accomplished intravascularly in the spleen. Degradation in soft tissue therefore leads to “foreign” metabolic process capable of inciting an inflammatory response. (Hematoxylin-eosin stain; × 69.) (Eagle RC Jr, Yanoff M: Anterior chamber cholesterolosis. Arch Ophthalmol 108:781, 1990.) |