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Isolated Bilateral Tarsal Conjunctival Immunoglobulin G4-related Ophthalmic Disease
Ann Optom Contact Lens 2020;19:22-25
Published online March 25, 2020
© 2020 The Korean Optometry & Contact Lens Study Society

Kyung Yun Kook, MD, Hyun Sik Moon, MD, Hyeon Jeong Yoon, MD, Won Choi, MD, PhD, Kyung Chul Yoon, MD, PhD

Department of Ophthalmology, Chonnam National University Medical School, Gwangju, Korea
Correspondence to: Kyung Chul Yoon, MD, PhD
Department of Ophthalmology, Chonnam National University Medical School, #42 Jebong-ro, Dong-gu, Gwangju 61469, Korea
Tel: 82-62-220-6741, Fax: 82-62-227-1642
Received August 19, 2019; Revised September 15, 2019; Accepted October 3, 2019.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Purpose: To report a case of isolated bilateral tarsal conjunctival immunoglobulin G4 (IgG4)-related ophthalmic disease.
Case summary: A 34-year-old male presented with both upper tarsal mass refractory with medical treatment at local hospital from 4 months ago. Slit-lamp examination showed elevated multi-lobular masses on both upper tarsal conjunctiva. Immunochemical stain on specimen showed the ratio of the IgG4+ to IgG+ cells was approximately over 80% and the mean number of IgG4-positive plasma cells was over 100 per high-power field. Therefore, we could finally diagnose his illness as IgG4-related ophthalmic disease. There was no evidence of systemic involvement in other examinations such as blood tests or radiologic examination performed in the rheumatology department of internal medicine.
Conclusions: IgG4-related ophthalmic disease is well known to occur in the orbit, especially in the lacrimal gland. However, there are no reported cases of tarsal conjunctival IgG4-related ophthalmic disease in Korea. Therefore, if a tumor is found in the tarsal conjunctiva, appropriate pathologic examination should be performed with the possibility of IgG4-related ophthalmic disease.
Keywords : Conjunctival neoplasms; IgG4-related ophthalmic disease; Immunoglobulin G4-related disease; Tarsal conjunctiva

March 2020, 19 (1)