Bilateral ptosis caused by localized superficial eyelid amyloidosis

A 70-year-old man had bilateral periorbital eyelid swelling. Eyelid biopsy confirmed amyloid infiltrate. Conjunctival involvement was not clinically apparent. The deposits were subsequently curetted with the use of a transcutaneous upper and lower eyelid blepharoplasty approach and found to be entirely pretarsal. No clinical recurrence of the ptosis was noted, but amyloid may have reaccumulated. We propose that in certain circumstances, debridement of localized amyloid should be considered and reaccumulation may not occur.