Introduction A great deal of important information can be obtained at autopsy of both adults and children by the pathologic examination of the eye and its adnexal structures. This information can be related to the cause of death (e.g., violent shaking trauma in physical child abuse) or pertain to disease processes affecting the eye, the orbit, and the surrounding structures outside the orbit. In this chapter I review the different methodologies that are required to remove eye and related

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... and the indications for electing to use these different procedures. I describe the reconstruction methods that are used to achieve the perfect cosmetic result that is so important when dealing with facial structures. I describe how to orientate, examine, and dissect the eye once it has been removed and how to record the important macroscopic pathologic findings in the eye. The chapter is directed primarily at histopathologists who do not have detailed knowledge of eye diseases, and it is intended as a basic guide to obtaining and safely securing the eye and related tissues at autopsy, for subsequent examination, perhaps by (or with) a specialist ophthalmic pathologist. Space does not allow me to cover the huge range of primary or secondary diseases affecting the eyes in children and adults, but I direct the reader to sources of this information. However, I do review one area -the ophthalmic pathology of child abuse -in more detail, because this topic has considerable forensic and medicolegal significance and because the detailed methodology and documentation at autopsy are so important and are prone to more than usual professional and public "scrutiny and interest." It is important to recognize that the eye and adnexal ocular structures are "culturally sensitive" tissues, and for this reason their removal must be approached cautiously. Removing these tissues should be undertaken only for sound scientific reasons, with the fully informed consent of the relatives and/or the coroner (or equivalent authority) and with properly agreed procedures for the eventual 1 This chapter has been adapted, reproduced, and expanded from Parsons MA, Start RD. Necropsy techniques in ophthalmic pathology. ACP Best Practice No. 164. J Clin Pathol 2001;54:417-427, adapted and reproduced with permission from the BMJ Publishing Group.