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   Table of Contents      
ARTICLE
Year : 1968  |  Volume : 16  |  Issue : 3  |  Page : 146-147

Primary amyloidosis of conjunctiva


Department of Ophthalmology,Jawaharlal Institute of Post-graduate Medical Education and Research, Pondicherry-6, India

Date of Web Publication24-Dec-2007

Correspondence Address:
N N Sood
Department of Ophthalmology,Jawaharlal Institute of Post-graduate Medical Education and Research, Pondicherry-6
India
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Source of Support: None, Conflict of Interest: None


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How to cite this article:
Sood N N, Ratnaraj A. Primary amyloidosis of conjunctiva. Indian J Ophthalmol 1968;16:146-7

How to cite this URL:
Sood N N, Ratnaraj A. Primary amyloidosis of conjunctiva. Indian J Ophthalmol [serial online] 1968 [cited 2020 Aug 10];16:146-7. Available from: http://www.ijo.in/text.asp?1968/16/3/146/37539

Amyloid tumours localized to the conjunctiva and eyelids are not a common finding. A number of cases of conjunctival amyloidosis have, how­ever, been described from India WA HI AND WAHI, [8] AGARWAL AND SHRIVASTAVA, [1] MATHUR AND MATHUR, [6] ISHWARCHANDRA AND SHARMA, [3] MALIK, MOHAN AND SOOD, [5] JAIN AND GUPTA [4] . All these cases reported have been from the trachoma endemic area.

We are reporting a case of amyloi­dosis of the conjunctiva, without any other chronic inflammation of the conjunctiva. This is the first case to he reported from Pondicherry (South­ern India).


  Case report Top


Thulasingam, Hindu, male aged 23 years, attended the Ophthalmic Out­patient Department of General Hos­pital, Pondicherry on 1-6-65 with a history of growth in the right lower lid of three months duration.

Apart from the fact that a slowly increasing swelling had been present for 3 months there was nothing else relevant in the history.

General Examination

The patient was a normal healthy adult male and there was no clinical evidence of local or systemic chronic inflammatory disease.

Local Examination

Right Eye:- There was a well lo­calised mass about the size of a pea in the right lower lid at the junction of the middle one third and lateral two thirds a few millimeters below the lid margin. The skin covering the swelling was stretched but freely movable and normal. The conjuncti­val aspect of the swelling revealed a yellowish globular translucent bulge, 4 mm x 4 mm merging into the tarsal plate. There was no evidence of trachoma or any other local abnor­mality.

The left eye was normal with a visual acuity of 6/6.

Investigations:

The patient at first was not willing for any surgical procedure but when he returned three weeks later, the tumour mass was completely excised on 23-6-65 under local anoesthesia. Post operative recovery was unevent­ful.

Biopsy Report:

Showed stratified squamous epithe­lium. The subepithelial layers show amyloid infiltration.


  Discussion Top


ASHTON AND REY [2] considered amyloid infiltration to be a specific form of hyaline infiltration, because of its specific staining reaction and known chemical composition. It is a glycoprotein, in which the carbo­hydrate ester, chondroiting sulphuric acid, is combined with a globulin. The amyloidosis developing in the conjunctiva may be primary or secon­dary. ASHTON AND REY [2] com­mented on various conditions which might be associated with secondary amyloidosis - long standing cases of spring catarrh, syphilis, pinguecula and pterygia. The association of trachoma and amyloidosis of con­junctiva has been brought out by se­veral Indian workers, viz AGARWAL AND SHRIVASTAVA, [1] MATHUR AND MATHUR, [6] ISHWARCHAN­DRA AND SHARMA. [3] In the case described by Agarwal and Shrivas­tava, there was bilateral amyloidosis probably secondary to trachoma. The two cases described by MATHUR AND MATHUR [6] from Rajasthan, (where 80% of the population has trachoma), did not show trachoma, clinically or microscopically. The authors assumed that it is not pos­sible to demonstrate inclusion bodies in later stages when amyloid changes have set in. In the case described by ISHWARCHANDRA AND SHARMA there was clinical evidence of trachoma, and the histological section showed infiltration with lymphocytes and plasma cells. The authors put it as a case of secondary amyloidosis.

MALIK, MOHAN AND SOOD [5] on the other hand described a case of primary amyloidosis without any evi­dence of trachoma. A study of his­topathological studies on the tarsal plate of a few established cases of trachoma did not show a single case of amyloidosis. Cases without tra­choma have also been described by RICHLIN AND KUWABARA. [7] It would be of interest to note in the case described by JAIN AND GUP­TA [4] amyloidosis was present in one eye while clinically trachoma was present in both eyes, and no cellular reactions noted in the tissues microscopically. Our case showed primary amyloidosis of conjunctiva of the primary type.


  Summary Top


A case of unilateral primary amy­loidosis of conjunctiva in a 23 years old male is described.


  Acknowledgement Top


We are grateful to Dr. A. Lesigneur, M. D., Medical Superintendent, General Hospital and Dr. D. J. Reddy, M.D., Prin­cipal, Jawaharlal Institute of Post-graduate Medical Education and Research, Pondi­cherry for permitting us to use the Hospi­tal Records.

 
  References Top

1.
AGARWAL, S., and SHRIVASTAV, J. B.: Amvloid Tumour of the Eye­lids, Brit. J. Ophthal. 42, 433, (1958).  Back to cited text no. 1
    
2.
ASHTON, N., and REY, A.: Hyaline Infiltration of the Eyelid. Brit. J. Ophth. 35, 125, (1951).  Back to cited text no. 2
    
3.
ISHWARA CHANDRA and SHAR­MA, K. D.: Amyloid Tumour of Con­junctiva: J. All-India Ophthal. Soc., 8: 72, (1960).  Back to cited text no. 3
    
4.
JAIN, N. S., and GUPTA, A. N.: Amyloidosis of the Conjunctiva. Brit. J. Ophthal. 50: 102, (1966).  Back to cited text no. 4
    
5.
MALIK, S. R. K., MOHAN. H., and SOOD, G. C.: Primary Amyloidosis of the Conjunctiva. Orient. Arch. Ophth. 2: 42, (1964).  Back to cited text no. 5
    
6.
MATHUR, S. P. and MATHUR, B. P.: Conjunctival Amyloidosis: Brit. J. Ophthal., 43: 765, (1959).  Back to cited text no. 6
    
7.
RICHLIN, J. J., KUWABARA, T.: Amyloid Disease of the Eyelid and Conjunctiva: Arch Ophthal. (Chicago, 67: 138, (1962).  Back to cited text no. 7
    
8.
WAHI, PASHPATI N, WAHI, P. N., and MATHUR K. N.: Amyloidosis of Conjunctiva.: J. All India Ophthal. Soc., 3, 45, (1954).  Back to cited text no. 8
    


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