[Hematological diagnosis in the corneal consultation]

Area of Science:

• Ophthalmology
• Hematology
• Pathology

Background:

• Corneal opacities can present atypically, sometimes masking underlying systemic conditions.
• Paraproteinemic keratopathy is a rare condition involving protein deposits in the cornea.

Observation:

• A patient presented with bilateral corneal opacity not typical for common eye diseases.
• Confocal microscopy revealed characteristic findings suggestive of paraproteinemic keratopathy.
• Initial clinical presentation prompted further investigation into systemic causes.

Findings:

• Hematological diagnostics confirmed monoclonal gammopathy of the IgG kappa type.
• Bone marrow biopsy definitively diagnosed lymphoplasmacytic lymphoma, a type of B-cell non-Hodgkin's lymphoma.

Implications:

• This case underscores the importance of considering systemic hematological disorders in patients with unexplained corneal conditions.
• Paraproteinemic keratopathy can serve as an early indicator of serious, potentially life-threatening hematological malignancies.
• Integrated diagnostic approaches combining ophthalmology and hematology are crucial for comprehensive patient care.