|Year : 1968 | Volume
| Issue : 3 | Page : 146-147
Primary amyloidosis of conjunctiva
NN Sood, A Ratnaraj
Department of Ophthalmology,Jawaharlal Institute of Post-graduate Medical Education and Research, Pondicherry-6, India
|Date of Web Publication||24-Dec-2007|
N N Sood
Department of Ophthalmology,Jawaharlal Institute of Post-graduate Medical Education and Research, Pondicherry-6
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Sood N N, Ratnaraj A. Primary amyloidosis of conjunctiva. Indian J Ophthalmol 1968;16:146-7
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,  AGARWAL AND SHRIVASTAVA,  MATHUR AND MATHUR,  ISHWARCHANDRA AND SHARMA,  MALIK, MOHAN AND SOOD,  JAIN AND GUPTA  . 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|| |
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.
The patient was a normal healthy adult male and there was no clinical evidence of local or systemic chronic inflammatory disease.
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.
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.
Showed stratified squamous epithelium. The subepithelial layers show amyloid infiltration.
| Discussion|| |
ASHTON AND REY  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  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,  MATHUR AND MATHUR,  ISHWARCHANDRA AND SHARMA.  In the case described by Agarwal and Shrivastava, there was bilateral amyloidosis probably secondary to trachoma. The two cases described by MATHUR AND MATHUR  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  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.  It would be of interest to note in the case described by JAIN AND GUPTA  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|| |
A case of unilateral primary amyloidosis of conjunctiva in a 23 years old male is described.
| Acknowledgement|| |
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|| |
AGARWAL, S., and SHRIVASTAV, J. B.: Amvloid Tumour of the Eyelids, Brit. J. Ophthal. 42, 433, (1958).
ASHTON, N., and REY, A.: Hyaline Infiltration of the Eyelid. Brit. J. Ophth. 35, 125, (1951).
ISHWARA CHANDRA and SHARMA, K. D.: Amyloid Tumour of Conjunctiva: J. All-India Ophthal. Soc., 8: 72, (1960).
JAIN, N. S., and GUPTA, A. N.: Amyloidosis of the Conjunctiva. Brit. J. Ophthal. 50: 102, (1966).
MALIK, S. R. K., MOHAN. H., and SOOD, G. C.: Primary Amyloidosis of the Conjunctiva. Orient. Arch. Ophth. 2: 42, (1964).
MATHUR, S. P. and MATHUR, B. P.: Conjunctival Amyloidosis: Brit. J. Ophthal., 43: 765, (1959).
RICHLIN, J. J., KUWABARA, T.: Amyloid Disease of the Eyelid and Conjunctiva: Arch Ophthal. (Chicago, 67: 138, (1962).
WAHI, PASHPATI N, WAHI, P. N., and MATHUR K. N.: Amyloidosis of Conjunctiva.: J. All India Ophthal. Soc., 3, 45, (1954).
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