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Corneal crystals: a precursor to cancer
1FAAO VA Medical Center, Hampton, VA, USA.
Summary
Corneal crystals can indicate serious systemic conditions like monoclonal gammopathy of undetermined significance (MGUS), which progressed to multiple myeloma. Early diagnosis of these immunoglobulin deposits is crucial for timely treatment.
Area of Science:
- Ophthalmology
- Nephrology
- Hematology
Background:
- Corneal crystalline deposits can signify various systemic conditions, some life-threatening.
- Identifying the etiology of corneal crystals is crucial, despite limited treatment options for the deposits themselves.
Observation:
- A 51-year-old male presented with glare due to diffuse corneal crystals.
- Slitlamp examination revealed subepithelial and anterior stromal crystals in both corneas.
Findings:
- The patient had a history of renal insufficiency and arthralgia.
- Systemic testing identified monoclonal gammopathy of undetermined significance (MGUS) which later progressed to multiple myeloma.
- Corneal crystals were composed of immunoglobulin (IgG) and excess kappa light chains.
Implications:
- Corneal crystals can be a manifestation of serious systemic diseases, including gammopathies.
- This case highlights the importance of laboratory testing and specialist referrals for patients with corneal crystals to rule out underlying systemic pathology.
- Prompt diagnosis and management of associated systemic conditions are vital.
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