|Year : 1973 | Volume
| Issue : 3 | Page : 140-142
Primary amyloidosis of eye-lid
G Ramaiah Chetty1, K Rajakumari2, C.R.R.M Reddy2
1 Department of Ophthalmology, Andhra Medical College, Visakhapatnam, India
2 Department of Pathology, Andhra Medical College, Visakhapatnam, India
G Ramaiah Chetty
Department of Ophthalmology, Andhra Medical College, Visakhapatnam
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Chetty G R, Rajakumari K, Reddy C. Primary amyloidosis of eye-lid. Indian J Ophthalmol 1973;21:140-2
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 ,,,, though at one time it was thought to be uncommon. , 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|| |
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.
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.
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%.
Blood group: `O'.
E.S.R.: 40 mm/hr .
Serum proteins: 7.6 gms%.
Biopsy of the swelling, gum and rectum was done.
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.
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|| |
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. ,, MALIK et al  and SOOD AND RATNARAJ have described primary amyloidosis of conjunctiva. AGARWAL AND SHRIVASTAVA  described one case with bilateral amyloidosis probably secondary to trachoma. CHANDRA AND SHARMA  described one case of secondary amyloidosis due to trachoma. MATHUR AND MATHUR  described two cases probably due to trachoma. JAIN AND GUPTA  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|| |
A case of primary amyloidosis of the eyelid is presented for its rarity.
| References|| |
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[Figure - 1], [Figure - 2]