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ARTICLES
Year : 1973  |  Volume : 21  |  Issue : 3  |  Page : 140-142

Primary amyloidosis of eye-lid


1 Department of Ophthalmology, Andhra Medical College, Visakhapatnam, India
2 Department of Pathology, Andhra Medical College, Visakhapatnam, India

Correspondence Address:
G Ramaiah Chetty
Department of Ophthalmology, Andhra Medical College, Visakhapatnam
India
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Source of Support: None, Conflict of Interest: None


PMID: 4500007

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How to cite this article:
Chetty G R, Rajakumari K, Reddy C. Primary amyloidosis of eye-lid. Indian J Ophthalmol 1973;21:140-2

How to cite this URL:
Chetty G R, Rajakumari K, Reddy C. Primary amyloidosis of eye-lid. Indian J Ophthalmol [serial online] 1973 [cited 2021 May 8];21:140-2. Available from: https://www.ijo.in/text.asp?1973/21/3/140/31392

Amyloid may occur in the eyelid and conjunctiva where it usually presents as a painless nodular swelling. Amyloidosis is not very uncommon in this country [6],[8],[10],[11],[14] though at one time it was thought to be uncom­mon. [8],[9] We came across recently a case of primary amyloidosis of the right upper and lower eyelids and the case is being presented because of its rarity.


  Case Report Top


B.S., a 16 year old girl came to the Ophthalmic Department with swelling of both the eyelids of the right eye and ulceration. The swelling of the eyelids started as a small nodular swelling at the margin of the lower lid 10 years back and there was ulceration of the conjunctival surface since one month. There was no pain or redness of the eye or watering of the eyes. The patient was unable to see with that eye as the swelling of the lids had completely closed the eye. There was no history of trauma. The other eye was perfectly normal with normal vision. General examination of the patient revealed no abnormality. Past history, family history and habits did not contribute any relevant information.

Right Eye:

Both the lids were swollen [Figure - 1] the swelling in the upper lid measured 5 x 3 cm and in the lower lid 3 x 4 cm. It was firm and lobulated. The swelling appeared to be extending far back into the lids. There was no involvement of the orbit. There was slight ulceration and discharge of the conjunctival surface. There was no proptosis. Separation of the eyelids with a retractor showed a normal cornea and bulbar conjunctiva. There was no evidence of trachoma in either eye.

The lower lid was turned out causing ectropion. There was no bleeding on touch.

Anterior chamber, iris and pupil were normal. Pupil was reacting to light. Movements of the eye were mechanically limited. Vision in the right eye was normal. Sac appeared normal. There was no evidence of preauricular or submandibular lympha­denopathy.

Investigations:

X-Ray chest: Normal.

No evidence of any tuberculosis.

Urine Nil abnormal.

Total W.B.C.: 9850/cmm.

The differential count showed a slightly higher count of eosino­phils 8%.

Haemoglobin 45%.

V.D.R.L.: Neg.

Blood group: `O'.

E.S.R.: 40 mm/hr .

Serum proteins: 7.6 gms%.

Biopsy of the swelling, gum and rec­tum was done.

Histopathology

The tissue consisted of a mass of amyloid material [Figure - 2] which was confirmed by staining with congo-red and viewing between crossed polars. Congo-red stained sections when view­ed in polarised light show greenish yellow birefringence.

Gingival and rectal biopsies did not reveal any amyloidosis.

Congo-red test

An intravenous congo-red test was done to rule out generalised amyloidosis. It showed only 25% retention showing that there was no generalised amyloidosis.


  Comment Top


The patient was otherwise healthy except for the presence of the swellings in the eye-lids. The swelling consisted of masses of amyloid tissue which was proved by congo-red staining and viewing between crossed polars. There was no evidence of tuberculosis, syphilis, chronic osteomyelitis or rheumatoid arthritis, which are the usual causes of generalised amyloidosis. Neither there was a local cause like trachoma for the amyloidosis. Urine was normal which ruled out a nephrotic syndrome. Gum biopsy, rectal biopsy and intravenous congo-red tests were negative, thus ruling out generalised amyloidosis. In the absence of known causes of amyloidosis, and also absence of any generalised amyloidosis the case is diagnosed as one of primary amyloidosis of the eyelid.

Association of trachoma and amyloidosis has been brought out by several Indian workers. [1],[2],[8] MALIK et al [7] and SOOD AND RATNARAJ[13] have described primary amyloidosis of conjunctiva. AGARWAL AND SHRIVAS­TAVA [1] described one case with bilate­ral amyloidosis probably secondary to trachoma. CHANDRA AND SHARMA [2] described one case of secondary amyloidosis due to trachoma. MATHUR AND MATHUR [8] described two cases probably due to trachoma. JAIN AND GUPTA [4] described unilateral amyloid of the eye in a case with bilateral trachoma. KHANNA AND SINGH (1969 described a case of primary amyloido­sis of the limbus.


  Summary Top


A case of primary amyloidosis of the eyelid is presented for its rarity.

 
  References Top

1.
Aganval, S., and Shrivastava, J. B.: Amyloid tumour of the eyelids, Brit. J. Ophthal., 42: 433, (1958).  Back to cited text no. 1
    
2.
Chandra, I., and Sharma, K. D.: Amyloid tumour of conjunctiva: J. All India Ophthal. Soc., 8: 72, (1960).  Back to cited text no. 2
    
3.
Gharpure, V. V.: Amyloidosis­A report of 7 cases. Ind. Med. Gaz., 86: 545, (1951).  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.
Khanna, K. K., and Singh, D.: Amyloidosis of the limbus. J. All India Ophthal. Soc., 17: 156, (1969).  Back to cited text no. 5
    
6.
Madangopal, A. V.: Conjunctival amyloidosis. Brit. J. Ophth., 46: 749, (1962).  Back to cited text no. 6
    
7.
Malik, S. R. K., Mohan, H., and Sood, G. C.: Primary amyloidosis of the conjunctiva. Orient. Arch. Ophthal., 2: 42, (1964).  Back to cited text no. 7
    
8.
Mathur, S. P., and Mathur, B. P.: Conjunctival amyloidosis - Brit. J. Ophth., 43: 765, (1959).  Back to cited text no. 8
    
9.
Reddy, D. J.: Amyloidosis. Ind. Med. Gaz., 86: 548, (1951).  Back to cited text no. 9
    
10.
Reddy, C.R.R.M., and Parvathi, G.: Amyloidosis. Ind. J. Med. Sci., 22: 770, (1968).  Back to cited text no. 10
    
11.
Reddy, C.R.R.M., Sulochana, G.; and Devi, C. S.: Amyloidosis a prospec­tive study. J. Ind. Med. Assoc., 56: 301, (1971).  Back to cited text no. 11
    
12.
Smith, M. E., and Zimmerman, L. E.: Amyloidosis of eyelid and conjunctiva. Arch. Ophth. (Chicago). 75: 42, (1966).  Back to cited text no. 12
    
13.
Sood, N. N., and Ratnaraj, A.: Primary amyloidosis of conjunctiva. J. All India Ophthal. Soc., 16: 146, (1968).  Back to cited text no. 13
    
14.
Wahi, P. N., Wahi, P. N., and Mathur, K. N.: Amyloidosis of conjunctiva, J. All India Ophthal. Soc., 2: 45, (1954).  Back to cited text no. 14
    


    Figures

  [Figure - 1], [Figure - 2]



 

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