| Bilateral Corneal Amyloidosis Extended into Visual Axis Secondary to Entropion and Distichiasis |
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Sung Rae Noh, Chan Min Yang, Tae Gi Kim, Kyung Hyun Jin |
Department of Ophthalmology, Kyunghee University Hospital, Kyunghee University College of Medicine1, Seoul, Korea
Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine2, Seoul, Korea |
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Received: 6 December 2016 • Revised: 3 January 2017 • Accepted: 3 January 2017 |
| Abstract |
Purpose: To report a rare case of bilateral secondary corneal amyloidosis with visual disturbance secondary to entropion and distichiasis.
Case summary: A 41-year-old man was referred to our clinic for the evaluation of decreased visual acuity in both eyes. Upon admission, the patient’s best-corrected visual acuity was 0.6 OD and count finger OS. External evaluation revealed entropion in both lower eyelids as well as distichiasis involving all 4 eyelids cause irritation to cornea. Slit-lamp examination revealed corneal opacity in the right peripheral cornea and left center cornea. The appearance of corneal opacity is gray-whitish circle with diameter 5 mm in right and 4 mm in left, also presented with gelatinous irregular surface and neovascularization in the right eye. Penetrating keratoplasty was performed for decreased visual acuity in the left eye. Histopathologic analysis of corneal button revealed deposition of amorphous, eosinophilic material just beneath the corneal epithelium. These opacities stained with Congo red and demonstrated apple green birefringence and dichroism. Secondary localized amyloidosis of the cornea was diagnosed without any systemic involvement. Entropion repair and hyfrecation was performed 1 month after penetrating keratoplasty. By the 4 years after penetrating keratoplasty, the patient’s best-corrected visual acuity was 0.9 OD and the patient showed no evidence of corneal graft rejection and recurrence of amyloidosis.
Conclusion: Irritation by eyelashes can cause corneal opacity and amyloidosis in patients with distichiasis or entropion. |
| Key Words:
Corneal amyloidosis; Distichiasis; Entropion; Penetrating keratoplasty |
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