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Cloudy corneas as an initial presentation of multiple myeloma
Priyanka Sharma1, Haifa A Madi1, Richard Bonshek2
1Sunderland Eye Infirmary, Sunderland, UK.
Clinical Ophthalmology (Auckland, N.Z.)
|May 10, 2014
Summary
A rare case of multiple myeloma was discovered in an 85-year-old woman presenting with cloudy vision due to cornea verticillata, a condition caused by protein deposits in the cornea.
Area of Science:
- Ophthalmology
- Hematology
- Pathology
Background:
- Multiple myeloma is a plasma cell malignancy.
- Corneal manifestations of multiple myeloma are uncommon.
- Paraprotein deposition can affect ocular tissues.
Observation:
- An 85-year-old female presented with a 4-month history of gradually worsening cloudy vision.
- Slit-lamp examination revealed extensive, bilateral, spiraling corneal epithelial opacities.
- The patient had a history of uneventful cataract surgery 7 years prior.
Findings:
- Histopathology and electron microscopy confirmed intracorneal paraprotein deposition.
- Further investigations revealed a previously undiagnosed low-grade multiple myeloma.
- Cornea verticillata was the presenting sign of the underlying plasma cell dyscrasia.
Implications:
- This case highlights a rare presentation of multiple myeloma.
- Ophthalmologists should consider systemic myeloma in patients with unexplained cornea verticillata.
- Early recognition of ocular signs can aid in diagnosing systemic hematologic disorders.
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