|Year : 1969 | Volume
| Issue : 4 | Page : 156-157
Amyloidosis of the limbus- case report
KK Khanna1, Daljit Singh2
1 Department of Ophthalmology, Medical College, Amritsar, India
2 Department of Ophthalmology, Medical College, Patiala, India
|Date of Web Publication||10-Jan-2008|
K K Khanna
Department of Ophthalmology, Medical College, Amritsar
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Khanna K K, Singh D. Amyloidosis of the limbus- case report. Indian J Ophthalmol 1969;17:156-7
Involvement of the cornea in amyloid degeneration is extremely rare. Schreiber (1913) noted involvement of whole of the cornea and Watanabe (1922) described amyloid degeneration of a band shaped area of the cornea. Presented here is a case of a young man who had an amyloid mass at the limbus which involved the upper half of the cornea and the adjacent sclera.
| Case Report|| |
T.S., 30 years old male, agricultural labourer, came with the complaints of a disfiguring mass in the right eye and deterioration of vision. The mass was noticed 2 years back as a moderately raised area by his physician when he complained of a constant difficulty in opening and closing the lid. He was advised to seek the aid of an ophthalmologist and get operated upon, but the advice was not heeded for two years. The mass had shown a particularly rapid increase in size during the last 1 year or so.
| Local Examination|| |
The lids were of normal thickness. Conjunctiva on both sides showed fine trachoma scarring. In the left eye a small regressed pannus was in evidence at the upper part of the cornea.
A mass was seen in the right eye, size about 1½ x 1 x ¾ cms, involving a little less than the upper half of the cornea and the adjacent sclera. The mass had a yellowish brown colour, a sharply defined margin and a smooth but slightly lobulated surface. A few somewhat enlarged vessels could be traced into the swelling. The consistency was hard. The conjunctiva and cornea around the swelling appeared perfectly normal [Figure - 1]. Local lymph glands showed no enlargement. Vision was 6/60, fundus and tension were normal.
The provisional diagnosis was either a benign growth or amyloidosis.
| Operation Notes|| |
The mass was removed as one piece. There was little difficulty in separating the mass from the scleral and corneal tissues. There was hardly any bleeding at the time of operation. Cutting the mass with a knife revealed a uniform yellow waxy appearance leaving no doubt about the diagnosis.
Histopathological examination confirmed the diagnosis of amyloidosis [Figure - 2].
The postoperative recovery was uneventful. The conjunctive grew over the defect in 15 days. The corneal epithelium grew more slowly. A thick leucoma resulted in the upper half of the cornea [Figure - 3]. His vision could not be improved beyond 6/24 with classes.
The patient was observed for a period of 1½ years. There was no recurrence.
| Discussion|| |
Amyloid degeneration of conjunctiva can result as a part of general systemic malady, as an incident in the disease process or as a separate disease. There is little doubt that our case belonged to the last category.
Considered in retrospect, the mass had all the features of amyloid, but the unusual site prevented us from making a firm diagnosis. However no doubt was left about the diagnosis at the time of the operation, because of lack of bleeding and typical appearance of the cut mass.
| Summary|| |
An unusual case of amyloid mass involving the upper half of the cornea and the adjacent sclera is described.
| References|| |
Duke Elder -System of Ophthalmology. Vol. VIII. part 1. p. 587. Henry Kimpton, London, 1965.
[Figure - 1], [Figure - 2], [Figure - 3]