Bilateral lacrimal gland amyloidosis: diagnostic implications of abnormal free light chains

Ocular amyloidosis is rare, and lacrimal gland involvement is even more uncommon. We present a case of bilateral lacrimal gland enlargement, diagnosed as amyloidosis through histopathological examination. Further evaluation revealed elevated serum free light chains with a positive difference between involved and uninvolved free light chains in electrophoresis, whereas all other investigations showed no evidence of systemic involvement. Although systemic amyloidosis was not identified, the presence of abnormal free light chains necessitates careful longitudinal surveillance. To the best of our knowledge, this represents only the third reported case of bilateral lacrimal gland amyloidosis in English literature.