Recurrent bilateral subconjunctival hemorrhage as an initial presentation of multiple myeloma

Felipe, Anthony F.; Nottage, Jennifer M.; Rapuano, Christopher J.

doi:10.4103/0974-620x.99384

Cited by 8 publications

(6 citation statements)

References 4 publications

(5 reference statements)

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“…The second cause of visits to an Eye Emergency Department is inflammatory ocular surface diseases, which are more frequent in older people with no difference related to sex, as observed by other authors (1, 4, 5, 17, 19, 20). A frequent cause of urgent access is phosphenes and floaters, which were reported by 5.7% of our patients, while a tear or retinal detachment is observed in 0.8% of cases.…”

Section: Discussionsupporting

confidence: 59%

“…Our study systematically investigating a series of patients attending the Eye Emergency Division of an Italian Regional Hospital shows that the incidence of emergencies on an annual basis, in relation to a population of about 200,000 inhabitants, is 3%. The most frequent causes of access were traumas, which are much more frequent in males and are equally common in all age groups after the age of 30 years: this is probably related to higher risk of injury in men from professional and domestic activities, as pointed out by other authors (1,4,7,(17)(18)(19)(20). Eye injury also occurs among children, as traumas are not exclusively associated with an occupation-related risk but can be related to leisure activities (1,18,21,22).…”

Section: Discussionmentioning

confidence: 79%

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Reasons for Visits to an Emergency Center and Hemostatic Alterations in Patients with Recurrent Spontaneous Subconjunctival Hemorrhage

Cagini

Iannone

Bartolini

et al. 2015

European Journal of Ophthalmology

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Section: Discussionsupporting

confidence: 59%

Section: Discussionmentioning

confidence: 79%

Reasons for Visits to an Emergency Center and Hemostatic Alterations in Patients with Recurrent Spontaneous Subconjunctival Hemorrhage

Cagini

Iannone

Bartolini

et al. 2015

European Journal of Ophthalmology

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“…General symptoms of MM include weight loss, lassitude, and bone pain [ 1 ]. Ocular findings include subconjunctival hemorrhage, hyper-viscous retinopathy, and ciliary body cyst [ 5 , 10 ]. However, corneal lesions are rare [ 1 , 5 , 11 ], and corneal opacity as an initial presentation of MM is also uncommon [ 1 , 2 , 4 , 5 , 11 , 12 ].…”

Section: Discussionmentioning

confidence: 99%

“…Rarely, blurred vision due to corneal opacity is an initial presentation of MM [ 1 , 2 , 7 ]. Ocular manifestations of MM are diverse, including cloudy cornea, subconjunctival hemorrhages, peripheral ulcerative keratitis, and band keratopathy [ 2 , 10 , 11 , 18 , 19 ]. Intriguingly, in our case, the only complaint was decreased vision.…”

Section: Discussionmentioning

confidence: 99%

Corneal Opacity Leading to Multiple Myeloma Diagnosis: A Case Report and Literature Review

Zhu

et al. 2018

Am J Case Rep

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Patient: Female, 54Final Diagnosis: Multiple myelomaSymptoms: A 9-month history of blurred visionMedication: Systemic chemotherapy with vincristine • cyclophosphamide • dexamethasoneClinical Procedure: Multiple myeloma patient presenting with corneal opacity and blurred vision as chief complaintSpecialty: Ophthalmology and HematologyObjective:Rare diseaseBackground:A multiple myeloma patient presenting with corneal opacity and blurred vision as chief complaint is rare.Case Report:A 54-year-old woman with a 9-month history of blurred vision without other systemic symptoms consulted an ophthalmologist. The patient had bilateral diffuse corneal opacity at the corneal epithelium and anterior stroma under slit-lamp examination. Decreased corneal endothelial cells density was found by microscopy. During consultation, the patient was noted to have an anemic face. Laboratory analysis and bone marrow were investigated. Serum protein electrophoresis revealed a raised serum kappa paraprotein band (12.4 g/L). The erythrocyte sedimentation rate (ESR) was accelerated to 49 mm/h (normal <20mm/h). There was mild kidney impairment. The blood urea increased to 8.1 mmol/L (normal <7.1 mmol/L) and creatinine increased to 158 μmol/L (normal <133 μmol/L). Then, a bone marrow biopsy was performed, showing 26% pleomorphic plasma cells (normal <15%). The patient was eventually diagnosed as having MM and was treated with systemic chemotherapy.Conclusions:Blurred vision due to corneal opacity can be an initial presentation of MM, of which ophthalmologists should be aware.

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“…Other ocular surface manifestations of multiple myeloma include repeated subconjunctival hemorrhages, 13 peripheral ulcerative keratitis, 14 prominent corneal nerves, 9 and band keratopathy. 15…”

Section: Discussionmentioning

confidence: 99%

Cloudy corneas as an initial presentation of multiple myeloma

Sharma

Madi

Bonshek

et al. 2014

OPTH

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SummaryWe report a case of previously unsuspected myeloma, presenting with cornea verticillata due to intracorneal paraprotein deposition.HistoryAn 85-year-old female presented via her optician with a 4-month history of cloudy vision. She had undergone an uneventful bilateral phacoemulsification surgery 7 years earlier. Extensive spiraling corneal epithelial opacification was noted on slit-lamp examination. On further investigation, she was found to have a previously unsuspected low-grade multiple myeloma. We established the nature of the corneal deposits with corneal epithelial biopsy histopathology and electron microscopy. It is very rare for multiple myeloma to present in this fashion. Ophthalmologists should be aware that such a presentation may rarely be due to systemic multiple myeloma.

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Recurrent bilateral subconjunctival hemorrhage as an initial presentation of multiple myeloma

Cited by 8 publications

References 4 publications

Reasons for Visits to an Emergency Center and Hemostatic Alterations in Patients with Recurrent Spontaneous Subconjunctival Hemorrhage

Reasons for Visits to an Emergency Center and Hemostatic Alterations in Patients with Recurrent Spontaneous Subconjunctival Hemorrhage

Corneal Opacity Leading to Multiple Myeloma Diagnosis: A Case Report and Literature Review

Cloudy corneas as an initial presentation of multiple myeloma

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